Shanks G Dennis
University of Queensland, School of Public Health, Brisbane, Australia.
Australian Army Malaria Institute, Enoggera, Australia.
Am J Trop Med Hyg. 2017 Dec;97(6):1804-1807. doi: 10.4269/ajtmh.17-0533. Epub 2017 Sep 28.
Blackwater fever is a massive hemolytic event usually occurring in the context of repeated falciparum malaria infections and intermittent quinine use. Its etiology is poorly understood, and it is rarely seen today. Historical epidemiological observations from the 20th century demonstrated variable patterns in prisoners in Andaman Islands, refugees in Macedonia, canal workers in Panama, expatriates in Rhodesia, and Second World War soldiers. Rates of blackwater fever per 1,000 malaria cases varied over two orders of magnitude. Islands, such as the Andaman Islands and New Guinea, had lower blackwater fever rates than continental areas. During the Second World War, blackwater fever rates in British soldiers in West Africa and Australian soldiers in New Guinea differed by a factor of 40 despite similar treatment regimens and falciparum malaria transmission risks. Blackwater fever is a complex interaction between host erythrocyte, falciparum malaria, and antimalarial drugs which remains poorly understood.
黑水热是一种大规模溶血事件，通常发生在反复感染恶性疟原虫和间歇性使用奎宁的情况下。其病因尚不清楚，如今已很少见。20世纪的历史流行病学观察表明，安达曼群岛的囚犯、马其顿的难民、巴拿马的运河工人、罗德西亚的侨民以及二战士兵中存在不同的发病模式。每1000例疟疾病例中的黑水热发病率相差两个数量级。安达曼群岛和新几内亚等岛屿的黑水热发病率低于大陆地区。二战期间，尽管治疗方案和恶性疟原虫传播风险相似，但西非的英国士兵和新几内亚的澳大利亚士兵的黑水热发病率相差40倍。黑水热是宿主红细胞、恶性疟原虫和抗疟药物之间的复杂相互作用，目前仍知之甚少。
