Comparison of parasite sequestration in uncomplicated and severe childhood Plasmodium falciparum malaria☆
| Autor: | Aubrey J. Cunnington, Sarah I. Nogaro, Michael T. Bretscher, Eleanor M. Riley, Michael Walther |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Male Erythrocytes HRP2 Plasmodium falciparum Malaria Cerebral Protozoan Proteins Anaemia Antigens Protozoan Parasitemia Models Biological Severity of Illness Index Article Statistics Nonparametric 03 medical and health sciences 0302 clinical medicine Severity of illness parasitic diseases medicine Parasite hosting Humans 030212 general & internal medicine Parasite Biomass Lactic Acid Malaria Falciparum Child Cerebral malaria 030304 developmental biology 0303 health sciences biology Microcirculation Case-control study Sequestration biology.organism_classification medicine.disease Pathophysiology 3. Good health Infectious Diseases Cerebral Malaria Case-Control Studies Child Preschool Immunology Regression Analysis Female Malaria |
| Zdroj: | The Journal of Infection |
| ISSN: | 1532-2742 0163-4453 |
| Popis: | Summary Objectives To determine whether sequestration of parasitized red blood cells differs between children with uncomplicated and severe Plasmodium falciparum malaria. Methods We quantified circulating-, total- and sequestered-parasite biomass, using a mathematical model based on plasma concentration of P. falciparum histidine rich protein 2, in Gambian children with severe ( n = 127) and uncomplicated ( n = 169) malaria. Results Circulating- and total-, but not sequestered-, parasite biomass estimates were significantly greater in children with severe malaria than in those with uncomplicated malaria. Sequestered biomass estimates in children with hyperlactataemia or prostration were similar to those in uncomplicated malaria, whereas sequestered biomass was higher in patients with severe anaemia, and showed a trend to higher values in cerebral malaria and fatal cases. Blood lactate concentration correlated with circulating- and total-, but not sequestered parasite biomass. These findings were robust after controlling for age, prior antimalarial treatment and clonality of infection, and over a realistic range of variation in model parameters. Conclusion Extensive sequestration is not a uniform requirement for severe paediatric malaria. The pathophysiology of hyperlactataemia and prostration appears to be unrelated to sequestered parasite biomass. Different mechanisms may underlie different severe malaria syndromes, and different therapeutic strategies may be required to improve survival. |
| Databáze: | OpenAIRE |
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