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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.

Original publication

DOI

10.1016/j.pt.2009.02.003

Type

Journal article

Journal

Trends Parasitol

Publication Date

05/2009

Volume

25

Pages

220 - 227

Keywords

Anemia, Animals, Child, Child, Preschool, Erythrocytes, Female, Host-Parasite Interactions, Humans, Infant, Infant, Newborn, Lung, Malaria, Vivax, Plasmodium vivax, Pregnancy, Pregnancy Complications, Parasitic, Severity of Illness Index, Virulence