Is asymptomatic malaria really asymptomatic? Hematological, vascular and inflammatory effects of asymptomatic malaria parasitemia

J Infect. 2015 Nov;71(5):587-96. doi: 10.1016/j.jinf.2015.08.005. Epub 2015 Aug 21.

Abstract

Asymptomatic malaria infections are highly prevalent in malaria endemic regions and most of these infections remain undiagnosed and untreated. Whereas conventional malaria symptoms are by definition absent, little is known on the more subtle health consequences of these infections. The aim of our study was to analyze the hematologic, vascular and inflammatory effects of patent and subpatent asymptomatic malaria parasitemia in children and adults on the Indonesian island Sumba. Both children and adults with parasitemia had increased high-sensitive C-reactive protein levels compared to aparasitemic individuals. In addition, children, but not adults with parasitemia also had lower platelet counts and Hb levels and higher levels of von Willebrand factor and platelet factor-4, markers of endothelial and platelet activation, respectively. These findings suggest that asymptomatic malaria infections have subtle health consequences, especially in children, and should be regarded as potentially harmful.

Keywords: Anemia; Asymptomatic; Endothelium; Inflammation; Malaria; Plasmodium falciparum; Plasmodium vivax; Platelets; von Willebrand factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anemia / etiology
  • Asymptomatic Infections* / epidemiology
  • C-Reactive Protein / analysis
  • Child
  • Female
  • Hemoglobins / analysis
  • Humans
  • Indonesia / epidemiology
  • Inflammation / immunology
  • Malaria / blood*
  • Malaria / epidemiology
  • Malaria / immunology*
  • Malaria / parasitology
  • Malaria, Falciparum / blood*
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / immunology*
  • Malaria, Falciparum / parasitology
  • Malaria, Vivax / blood*
  • Malaria, Vivax / immunology*
  • Malaria, Vivax / parasitology
  • Male
  • Middle Aged
  • Parasitemia
  • Plasmodium falciparum / isolation & purification
  • Plasmodium vivax / isolation & purification
  • Platelet Activation
  • Platelet Count
  • Platelet Factor 4 / blood
  • Seasons
  • Young Adult
  • von Willebrand Factor / analysis

Substances

  • Hemoglobins
  • von Willebrand Factor
  • Platelet Factor 4
  • C-Reactive Protein