The pathophysiology of vivax malaria.
Long considered a benign infection, Plasmodium vivax is now recognized as a cause of severe and fatal malaria, despite its low parasite biomass, the increased deformability of vivax-infected red blood cells and an apparent paucity of parasite sequestration. Severe anemia is associated with recurrent bouts of hemolysis of predominantly uninfected erythrocytes with increased fragility, and lung injury is associated with inflammatory increases in alveolar-capillary membrane permeability. Although rare, vivax-associated coma challenges our understanding of pathobiology caused by Plasmodium spp. Host and parasite factors contribute to the risk of severe disease, and comorbidities might contribute to vivax mortality. In this review, we discuss potential mechanisms underlying the syndromes of uncomplicated and severe vivax malaria, identifying key areas for future research.
International Health Division, Menzies School of Health Research and Charles Darwin University, Darwin 0810, Australia. anstey@menzies.edu.au
Nicholas M
NM
Anstey
Bruce
B
Russell
Tsin W
TW
Yeo
Ric N
RN
Price
D000740:Anemia / Q000469:parasitology / Q000503:physiopathology; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000469:parasitology / Q000473:pathology; D005260:Female; D006790:Host-Parasite Interactions; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000469:parasitology / Q000473:pathology; D016780:Malaria, Vivax / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology*; D010966:Plasmodium vivax / Q000472:pathogenicity / Q000502:physiology*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology; D012720:Severity of Illness Index; D014774:Virulence