Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens
Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of i...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-11-01
|
| Series: | Tropical Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2414-6366/9/11/279 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850147065236029440 |
|---|---|
| author | Chiadika Nwanze Daniel Muller Priscilla Suleman Mrinmayee Takle John R. Barber Kyle J. Wilson Nicholas A. V. Beare Karl B. Seydel Douglas G. Postels |
| author_facet | Chiadika Nwanze Daniel Muller Priscilla Suleman Mrinmayee Takle John R. Barber Kyle J. Wilson Nicholas A. V. Beare Karl B. Seydel Douglas G. Postels |
| author_sort | Chiadika Nwanze |
| collection | DOAJ |
| description | Two-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular whitening, retinal hemorrhages, and vessel color changes) with the total, circulating, or sequestered parasite load in children with CM. Total parasite burden was estimated by measuring plasma levels of Plasmodium falciparum histidine-rich protein 2 (PfHRP2), while the sequestered load was calculated as the difference between the total burden and circulating parasitemia. Children with retinopathy-positive CM (n = 172) had higher total and sequestered parasite burdens compared to retinopathy-negative children (n = 42) (both <i>p</i> = 0.049). In a subgroup with detailed retinopathy grading (n = 52), more extensive vessel color changes correlated with higher total, sequestered, and circulating parasite loads (<i>p</i> = 0.0057, <i>p</i> = 0.0068, and <i>p</i> = 0.0433, respectively). Peripheral retinal whitening was also associated with increased total and sequestered loads (<i>p</i> = 0.0017 and <i>p</i> = 0.0012). No association was found between retinal hemorrhages and parasite burden, indicating that other factors may influence their pathogenesis. |
| format | Article |
| id | doaj-art-e11e8a64a02b4c62bd23a37905831acd |
| institution | OA Journals |
| issn | 2414-6366 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj-art-e11e8a64a02b4c62bd23a37905831acd2025-08-20T02:27:40ZengMDPI AGTropical Medicine and Infectious Disease2414-63662024-11-0191127910.3390/tropicalmed9110279Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite BurdensChiadika Nwanze0Daniel Muller1Priscilla Suleman2Mrinmayee Takle3John R. Barber4Kyle J. Wilson5Nicholas A. V. Beare6Karl B. Seydel7Douglas G. Postels8Department of Pediatrics, Children’s National Hospital, Washington, DC 20010, USAGeorge Washington School of Medicine and Health Sciences, Washington, DC 20052, USABlantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, MalawiDivision of Neurology, Children’s National Hospital, Washington, DC 20010, USADivision of Biostatistics and Study Methodology, Children’s National Hospital, Washington, DC 20010, USADivision of Neurology, Children’s National Hospital, Washington, DC 20010, USADepartment of Eye & Vision Science, University of Liverpool, Liverpool L7 8TX, UKBlantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, MalawiBlantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, MalawiTwo-thirds of children with cerebral malaria (CM) exhibit retinopathy characterized by whitening, vessel color changes, and/or hemorrhages. The pathogenesis of malarial retinopathy is not fully understood. This study aimed to assess the relationship between malarial retinopathy and the severity of its components (macular whitening, retinal hemorrhages, and vessel color changes) with the total, circulating, or sequestered parasite load in children with CM. Total parasite burden was estimated by measuring plasma levels of Plasmodium falciparum histidine-rich protein 2 (PfHRP2), while the sequestered load was calculated as the difference between the total burden and circulating parasitemia. Children with retinopathy-positive CM (n = 172) had higher total and sequestered parasite burdens compared to retinopathy-negative children (n = 42) (both <i>p</i> = 0.049). In a subgroup with detailed retinopathy grading (n = 52), more extensive vessel color changes correlated with higher total, sequestered, and circulating parasite loads (<i>p</i> = 0.0057, <i>p</i> = 0.0068, and <i>p</i> = 0.0433, respectively). Peripheral retinal whitening was also associated with increased total and sequestered loads (<i>p</i> = 0.0017 and <i>p</i> = 0.0012). No association was found between retinal hemorrhages and parasite burden, indicating that other factors may influence their pathogenesis.https://www.mdpi.com/2414-6366/9/11/279malariapediatricsretinopathy |
| spellingShingle | Chiadika Nwanze Daniel Muller Priscilla Suleman Mrinmayee Takle John R. Barber Kyle J. Wilson Nicholas A. V. Beare Karl B. Seydel Douglas G. Postels Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens Tropical Medicine and Infectious Disease malaria pediatrics retinopathy |
| title | Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens |
| title_full | Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens |
| title_fullStr | Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens |
| title_full_unstemmed | Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens |
| title_short | Severity of Vessel Color Changes and Macular and Peripheral Whitening in Malarial Retinopathy Are Associated with Higher Total Body and Sequestered Parasite Burdens |
| title_sort | severity of vessel color changes and macular and peripheral whitening in malarial retinopathy are associated with higher total body and sequestered parasite burdens |
| topic | malaria pediatrics retinopathy |
| url | https://www.mdpi.com/2414-6366/9/11/279 |
| work_keys_str_mv | AT chiadikanwanze severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT danielmuller severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT priscillasuleman severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT mrinmayeetakle severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT johnrbarber severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT kylejwilson severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT nicholasavbeare severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT karlbseydel severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens AT douglasgpostels severityofvesselcolorchangesandmacularandperipheralwhiteninginmalarialretinopathyareassociatedwithhighertotalbodyandsequesteredparasiteburdens |