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Open Access Highly Accessed Review

The anaemia of Plasmodium vivax malaria

Nicholas M Douglas123*, Nicholas M Anstey13, Pierre A Buffet456, Jeanne R Poespoprodjo178, Tsin W Yeo13, Nicholas J White29 and Ric N Price123

Author Affiliations

1 Global Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia

2 Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK

3 Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia

4 INSERM - UPMC, (Paris 6 University) UMRs945, F-75013, Paris, France

5 Department of Parasitology, Pitié-Salpétrière Hospital, Assistance Publique – Hôpitaux de Paris, F-75013, Paris, France

6 Institut Pasteur, Unité d’Immunologie Moléculaire des Parasites, Département de Parasitologie Mycologie, F-75015, Paris, France

7 Mimika District Health Authority, Timika, Papua, Indonesia

8 Papuan Health and Community Development Foundation, Timika, Papua, Indonesia

9 Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

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Malaria Journal 2012, 11:135  doi:10.1186/1475-2875-11-135

Published: 27 April 2012

Abstract

Plasmodium vivax threatens nearly half the world’s population and is a significant impediment to achievement of the millennium development goals. It is an important, but incompletely understood, cause of anaemia. This review synthesizes current evidence on the epidemiology, pathogenesis, treatment and consequences of vivax-associated anaemia. Young children are at high risk of clinically significant and potentially severe vivax-associated anaemia, particularly in countries where transmission is intense and relapses are frequent. Despite reaching lower densities than Plasmodium falciparum, Plasmodium vivax causes similar absolute reduction in red blood cell mass because it results in proportionately greater removal of uninfected red blood cells. Severe vivax anaemia is associated with substantial indirect mortality and morbidity through impaired resilience to co-morbidities, obstetric complications and requirement for blood transfusion. Anaemia can be averted by early and effective anti-malarial treatment.

Keywords:
Plasmodium vivax; Malaria; Anaemia; Epidemiology; Pathogenesis