Malaria-related Anaemia

Menéndez, Clara; Fleming, A. F.; Alonso, Pedro L.

doi:10.1016/s0169-4758(00)01774-9

Cited by 386 publications

(345 citation statements)

References 56 publications

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“…However, this observa- tion was never seen again in the literature. Likewise, a "dysmegakaryopoiesis" was proposed, similar to what happened in the human malarial anaemia model, where dyserythropoiesis was triggered by cytokines (Menendez et al 2000). In the few studies that examined the bone marrow for this purpose, megakaryocytic lineage was apparently preserved (Naveira 1970, Beale et al 1972.…”

mentioning

confidence: 90%

Thrombocytopenia in malaria: who cares?

Lacerda

Mourão

Coelho

et al. 2011

Mem. Inst. Oswaldo Cruz

182

173

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Key words: Plasmodium falciparum -Plasmodium vivax -malaria -thrombocytopenia -plateletsMalaria and thrombocytopenia • Marcus Vinícius Guimarães Lacerda et al. 53Data on the real burden of thrombocytopenia associated with malaria is contradictory in the literature and it is not usually considered when conducting patient selection. Table I shows the major publications estimating the frequency of thrombocytopenia. Most of these data were published in the late 1990s, probably in time with the surge in the availability of affordable automated machines capable of performing full blood counts (FBC). Manual platelet counting is time-consuming and usually needs to be requested by the physician with the routine blood count in most of the endemic areas for malaria. In only three publications is there an adequate randomised enrollment of patients with appropriate sample size calculation to estimate the frequency of bleeding and its association with the respective platelet count (Lacerda 2007, Silva 2009, Kochar et al. 2010. Only one study has ruled out other common causes of thrombocytopenia that are also endemic in the studied area (Lacerda 2007). There is a wide range of thrombocytopenia occurrence in these reports, which may be explained by distinct selection criteria of the enrolled patients. There are also differences in the selection of outpatients or inpatients from tertiary care centres that tend to present with severe thrombocytopenia. Furthermore, clinical manifestations of thrombocytopenia are usually described as case reports and most of these are due to P. vivax (Table II).In 2005, 138 of 684 (20.1%) malarial cases hospitalised in a tertiary care centre in Manaus had thrombocytopenia as the cause of admission, which corresponded to 6.8% of hospitalisations due to all causes in this reference institution (unpublished observations). Hospitalisation, however, does not add any benefit to the patient and because there is no evidence for any intervention, this simply increases public health costs in underdeveloped and under-resourced areas.Pathogenesis of malarial thrombocytopenia -Coagulation disturbances -A study based on 31 American soldiers in Vietnam with chloroquine-resistant falciparum malaria noted the following changes in the acute phase of the disease using the same patients as their own controls during convalescence: decrease in the platelet count and prothrombim activation time, increase in the activated thromboplastin time, and reduction in factors V, VII and VIII with normal fibrinogen (Dennis et al. 1967). This report suggested that thrombocytopenia was simply a consequence of the coagulation disorders presented by these patients, an idea that persisted for many decades in the literature. In another series of 21 patients with falciparum malaria, six had developed disseminated intravascular coagulation (DIC). The authors noted that the patients with more severe thrombocytopenia also had DIC and that there was correlation between platelet count and C3 protein levels. However, the reduction in C3 was pr...

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mentioning

confidence: 90%

Thrombocytopenia in malaria: who cares?

Lacerda

Mourão

Coelho

et al. 2011

Mem. Inst. Oswaldo Cruz

182

173

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“…Modified DATs for IgG and complement component C3d were performed on days 1,4,8,13,16,20,24, and 28 of the 28-day follow-up period; all tests in all monkeys were negative.…”

Section: -Tailed T-test)mentioning

confidence: 99%

“…Suppressive autologous serum factors, reduced erythropoietin synthesis, and alterations in cytokine production may be part of anemia development. 1 Not only does it seem that the anemia of malaria is caused by more than one factor, but there are also different forms of malarial anemia. In their study of anemia in young Gambian children, Abdalla and others 2 were able to divide the subjects into 3 groups (acute malaria, anemic acute malaria, and chronic anemic malaria), depending on factors such as history, parasitemia density, degree of illness, and hemoglobin concentration.…”

Section: Introductionmentioning

confidence: 99%

Anemia in parasite- and recombinant protein-immunized aotus monkeys infected with Plasmodium falciparum.

Jones

Stroncek²,

Gozalo³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. Plasmodium falciparum-induced anemia was characterized in Aotus monkeys repeatedly immunized by infection with P. falciparum (FVO strain) parasites, then cross-challenged with CAMP strain, or in monkeys receiving blood stage challenges as part of malaria vaccine trials. In 4 studies, 25 (30.5%) of 82 monkeys had at least a 50% reduction in hematocrit; mean day of maximum parasitemia was 12.5, whereas the mean day of minimum hematocrit was 18.8 (P < 0.0009). Decreased hematocrit levels were not associated with reticulocytosis until parasite densities decreased significantly from peak levels. Direct antibody tests to detect IgG and C3d on the surface of erythrocytes were negative. Nonantibody/noncomplement-mediated lysis of uninfected erythrocytes seems to be the principal cause of the anemia, and it also seems that bone marrow suppression and lysis of infected erythrocytes contributed to the anemia. Partial immunity-whether induced by repeated immunization with whole parasites or with vaccine-seems important to the development of anemia.

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“…The impact of malaria-related anemia on pregnant women (id est., the risk of death) and fetuses (i.e., low birthweight) has been increasingly acknowledged during the last decades 12,13 , keeping in mind that anemia does not necessarily have to be symptomatic to become a risk factor during pregnancy. Low birth weight in newborns from mothers who had malaria during pregnancy is common; it is estimated that it causes 5% of perinatal deaths in areas with poor resources 14 .…”

Section: Introductionmentioning

confidence: 99%

Plasmodium falciparum infection in pregnant women attending antenatal care in Luanda, Angola

Campos

Valente

Campos³

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Malaria during pregnancy remains a serious public health problem. The aim of this study was to establish the prevalence and possible risk factors for malaria in pregnant women attending antenatal care at Augusto Ngangula Specialized General Hospital in Luanda, Angola. Methods: Pregnant women (679 total) who attended antenatal care from April to September 2008 were included in the study after signing informed consent. For each participant, the social-demographic profile and malaria and obstetric histories were investigated via a questionnaire. Diagnosis was made by optic microscopy, and hemoglobin concentration measured. The associations between age, parity, gestational age, residence, schooling, malaria during gravity, anemia and treatment with incidence of Plasmodium falciparum infection were analyzed through logistic regression. Results: During the period of study, 74 (10.9%) out of 679 women were infected by P. falciparum. The average concentration of hemoglobin was 11.1 ± 0.07g/dL, and there were significant associations between the history of malaria during pregnancy, P. falciparum infection (p<0.01) and anemia at the time of observation (p<0.001). Conclusions: Previous history of malaria during pregnancy represents a risk factor for current infection and anemia was an important complication associated with malaria, even in women who were treated with sulfadoxine-pyrimethamine during pregnancy.

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Malaria-related Anaemia

Cited by 386 publications

References 56 publications

Thrombocytopenia in malaria: who cares?

Thrombocytopenia in malaria: who cares?

Anemia in parasite- and recombinant protein-immunized aotus monkeys infected with Plasmodium falciparum.

Plasmodium falciparum infection in pregnant women attending antenatal care in Luanda, Angola

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