Blackwater fever (BWF), one of the most severe and life-threatening forms of falciparum malaria, is characterized by acute massive intravascular haemolysis, often leading to acute renal failure. Thus far, the genetics of the underlying susceptibility to develop BWF is not fully elucidated. Deficiency in the MBL protein, an important component of the innate immune system, has previously been suggested to be a susceptibility factor for the development of severe malaria. This study aimed to evaluate the association between MBL2 gene polymorphisms, known to affect the MBL protein level/activity, and the occurrence of BWF among Congolese children.
Multiple red blood cell (RBC) variants appear to offer protection against the most severe forms of Plasmodium falciparum malaria. Associations between these variants and uncomplicated malaria are less clear.
The epidemiology of febrile illness etiologies is under-explored in resource-poor settings. Establishing a local repertory of microorganisms circulating in blood of febrile and afebrile people is important for physicians. Blood was collected from 428 febrile and 88 afebrile children in Makokou (Gabon) and analyzed using polymerase chain reaction. Plasmodium spp. were the pathogens, which were most detected in febrile children (69.6%; 298/428) and in afebrile children (31.8%; 28/88) (P < 0.0001).
Malaria is a major health, economic, and social burden in sub-Saharan Africa. The objective is to help understanding the economic impact of malaria and informing estimates of the potential economic impact of malaria prevention. To achieve this, we conducted a systematic review of published information on health system costs, health care resource use, and household costs for the management of malaria episodes in children aged <5 years in sub-Saharan Africa.
Higher chloroquine doses can effectively treat up to 93-96% of malaria infections caused by P. falciparum carrying the resistance conferring chloroquine resistance transporter (pfcrt) 76T allele. The tolerability of 50 (double standard dose) and 70 mg/kg total chloroquine doses were assessed in this study.
Artemisinin-based combination therapy (ACT) is recommended to improve malaria treatment efficacy and limit drug-resistant parasites selection in malaria endemic areas. 5 years after they were adopted, the efficacy and safety of artemether–lumefantrine (AL) and artesunate–amodiaquine (ASAQ), the first-line treatments for uncomplicated malaria were assessed in Burkina Faso.
In large parts of sub-Saharan Africa, the start of the seasonal rains means that within weeks, hospitals will witness a sharp upsurge in admissions to their pediatric wards. Many children who are admitted will be suffering from life-threatening complications of Plasmodium falciparum malaria, such as coma and convulsions (cerebral malaria), severe anemia (requiring urgent lifesaving transfusion), and rapid breathing (due to severe metabolic acidosis).
Parenteral artesunate for the treatment of severe malaria in non-immune travelers is associated with late-onset hemolysis. In children in sub-Saharan Africa, the hematologic effects of malaria and artesunate are less well documented. Here we report a prospective case series of 91 children with severe malaria treated with parenteral artesunate, managed at a resource-poor hospital in Africa, with longitudinal data on hemoglobin (Hb), lactate dehydrogenase (LDH), haptoglobin, and erythrocyte morphology.
Although malaria remains one of the major public health threats in inter-tropical areas, there is limited understanding of imported malaria in children by paediatricians and emergency practitioners in non-endemic countries, often resulting in misdiagnosis and inadequate treatment. Moreover, classical treatments (atovaquone-proguanil, quinine, mefloquine) are limited either by lengthy treatment courses or by side effects. Since 2010, the World Health Organization (WHO) has recommended the use of oral artemisinin-based combination therapy for the treatment of uncomplicated Plasmodium falciparum malaria worldwide. The benefits of artenimol–piperaquine in children have been validated in endemic countries but experience remains limited in cases of imported malaria.
Cerebral malaria (CM) accounts for nearly 400,000 deaths annually inAfrican children. Current dogma suggests that CM results from infected RBC (iRBC)sequestration in the brain microvasculature and resulting sequelae. Therapies targetingthese events have been unsuccessful; findings in experimental models suggest that CD8+ Tcells drive disease pathogenesis. However, these data have largely been ignored becausecorroborating evidence in humans is lacking. This work fills a critical gap in ourunderstanding of CM pathogenesis that is impeding development of therapeutics.