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Falciparum malaria after splenectomy: a prospective controlled study of 33 previously splenectomized Malawian adults

Bach, O., Baier, M., Pullwitt, A., Fosiko, N., Chagaluka, G., Kalima, M., Pfister, W., Straube, E. and Molyneux, Malcolm E (2005) 'Falciparum malaria after splenectomy: a prospective controlled study of 33 previously splenectomized Malawian adults'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 99, Issue 11, pp. 861-867.

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Abstract

We identified 33 Malawians who had undergone total splenectomy for traumatic injury. We reviewed these and 33 controls by clinical and parasitological examination monthly for 1 year. Splenectomized patients (S) were 2.5 times as likely as controls (C) to complain about febrile symptoms during the month preceding a visit (P < 0.0001). They were nearly twice as likely as controls to have Plasmodium falciparum parasitaemia (S: 176/283 person visits; C: 86/262; P < 0.0001). Parasitaemia was more likely to be associated with febrile symptoms in splenectomized individuals (S: 104/176, 59%; C: 24/86, 28%; P < 0.0001). There were three deaths (two non-malarial, one unexplained) among splenectomized subjects and none in the control group. Parasite densities reached significantly higher levels, and mature parasite stages were more often seen in the peripheral blood, in asplenic individuals. In a partially immune population, asplenic individuals are at increased risk of malarial infections and illness. In a larger group without the benefit of regular review and prompt therapy, there may be an increased risk of life-threatening malaria. Splenectomy should be avoided when possible in an area with endemic transmission of P falciparum. (c) 2005 Published by Elsevier Ltd on behalf of Royal Society of Tropical Medicine and Hygiene.

Item Type: Article
Uncontrolled Keywords: splenectomy ruptured spleen plasmodium falciparum partial immunity splenic repair trophozoites plasmodium-falciparum infected erythrocytes spleen yoelii cytoadherence responses mice
Subjects: WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WH Hemic and Lymphatic Systems > Lymphatic System > WH 600 Spleen
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1016/j.trstmh.2005.03.008
Depositing User: Ms Julia Martin
Date Deposited: 01 Aug 2011 10:33
Last Modified: 06 Feb 2018 13:03
URI: https://archive.lstmed.ac.uk/id/eprint/1964

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