title: Is asymptomatic malaria really asymptomatic? Hematological, vascular and inflammatory effects of asymptomatic malaria parasitemia.
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.
authors: Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands. Electronic address: Quirijn.demast@radboudumc.nl.
authors: Quirijn
authors: Q
authors: de Mast
authors: Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands.
authors: Judith
authors: J
authors: Brouwers
authors: Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
authors: Din
authors: D
authors: Syafruddin
authors: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom.
authors: Teun
authors: T
authors: Bousema
authors: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Amrish Y
authors: AY
authors: Baidjoe
authors: Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands.
authors: Philip G
authors: PG
authors: de Groot
authors: Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Andre J
authors: AJ
authors: van der Ven
authors: Department of Clinical Chemistry and Haematology, University Medical Centre, Utrecht, The Netherlands.
authors: Rob
authors: R
authors: Fijnheer
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology; D058345:Asymptomatic Infections / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007249:Inflammation / Q000276:immunology; D008288:Malaria / Q000097:blood* / Q000453:epidemiology / Q000276:immunology* / Q000469:parasitology; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology / Q000276:immunology* / Q000469:parasitology; D016780:Malaria, Vivax / Q000097:blood* / Q000276:immunology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D018512:Parasitemia; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D015539:Platelet Activation; D010976:Platelet Count; D010978:Platelet Factor 4 / Q000097:blood; D012621:Seasons; D055815:Young Adult; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D006454:Hemoglobins; D014841:von Willebrand Factor; D010978:Platelet Factor 4; D002097:C-Reactive Protein
keywords: Anemia; Asymptomatic; Endothelium; Inflammation; Malaria; Plasmodium falciparum; Plasmodium vivax; Platelets; von Willebrand factor