Rolling Christina Charlotte, Phillips Richard O, Abass Kabiru Mohammed, Ken Adu Poku Joseph, Osei-Mireku Samuel, Osei-Wusu Bright, Thompson William, Vinnemeier Christof D, Huebl Lena, Langer Florian, Francke Paul, Kuta Piotr, Konrath Sandra, Renné Thomas, Tannich Egbert, Rolling Thierry, Heinemann Melina
Department of Oncology and Hematology, Bone Marrow Transplantation with section of Pneumology, Hubertus Wald Tumorzentrum-University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Open Forum Infect Dis. 2023 Feb 18;10(3):ofad074. doi: 10.1093/ofid/ofad074. eCollection 2023 Mar.
Coagulopathy is common in acute symptomatic malaria, and the degree of coagulation abnormality correlates with parasitemia and disease severity. Chronic asymptomatic malaria has been associated with increased morbidity. However, the role of coagulation activation in asymptomatic, semi-immune individuals remains unclear. This study investigates the potential effect of asymptomatic infection on coagulation activation in semi-immune Ghanaian adults.
Blood from asymptomatic Ghanaian adults with blood stage infection detectable by polymerase chain reaction (PCR) or by both PCR and rapid diagnostic test and from noninfected individuals, was investigated. Markers of coagulation activation including global coagulation tests, D-dimer, antithrombin III, fibrinogen, and von Willebrand factor antigen were tested. Furthermore, blood count, inflammation markers, and liver and kidney function tests were assessed.
Acquired coagulopathy was not found in asymptomatic infection. Asymptomatic malaria was associated with significantly lower platelet counts. Systemic inflammation markers and liver and kidney function tests were not altered compared to noninfected controls.
There is no laboratory evidence for acquired coagulopathy in adults with asymptomatic malaria in highly endemic regions. Lack of laboratory evidence for systemic inflammation and liver and kidney dysfunction indicates that asymptomatic malaria may not be associated with significant morbidity.
凝血功能障碍在急性症状性疟疾中很常见，凝血异常程度与寄生虫血症及疾病严重程度相关。慢性无症状疟疾与发病率增加有关。然而，凝血激活在无症状、半免疫个体中的作用仍不清楚。本研究调查了无症状感染对半免疫加纳成年人凝血激活的潜在影响。
对通过聚合酶链反应（PCR）或同时通过PCR和快速诊断检测出有血期感染的无症状加纳成年人以及未感染个体的血液进行研究。检测了凝血激活标志物，包括全血凝血试验、D-二聚体、抗凝血酶III、纤维蛋白原和血管性血友病因子抗原。此外，还评估了血细胞计数、炎症标志物以及肝肾功能检查。
在无症状感染中未发现获得性凝血功能障碍。无症状疟疾与血小板计数显著降低有关。与未感染对照组相比，全身炎症标志物以及肝肾功能检查未发生改变。
在高度流行地区，无症状疟疾成年人中没有获得性凝血功能障碍的实验室证据。缺乏全身炎症以及肝肾功能障碍的实验室证据表明，无症状疟疾可能与显著的发病率无关。
