Caucaseco Scientific Research Center, Cali, Colômbia.
Mem Inst Oswaldo Cruz. 2011 Aug;106 Suppl 1(Suppl 1):91-104. doi: 10.1590/s0074-02762011000900012.
Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA), malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria.
疟疾是全球最重要的寄生虫病,每年估计有 2.25 亿例临床病例。它主要影响儿童、孕妇和非免疫成年人,这些人经常因脑部表现和贫血而死亡。尽管美洲大陆对全球疟疾负担的贡献每年仅约为 120 万例临床病例,但该地区有 1.7 亿居民面临疟疾传播的风险。在非洲大陆,恶性疟原虫是最常见的人类疟疾寄生虫,贫血约占疟疾相关死亡的一半。相反,在拉丁美洲(LA),与疟疾相关的贫血似乎并不常见,尽管关于其实际流行率的知识有限。这可能部分归因于几个因素,包括 LA 的总体疟疾负担明显低于非洲,该地区主要的疟原虫物种间日疟原虫(Plasmodium vivax)似乎表现出不同的临床特征,而且很可能因为 LA 的医疗服务更好,从而预防了严重疟疾病例的发生。为了帮助理解疟疾相关贫血在 LA 的真正重要性,我们在此讨论了对该主题的现有文献的综述,以及实验动物模型的实用性,包括新世界猴,特别是用于研究疟疾发病机制中涉及的机制。