Patients presenting with severe falciparum malaria in a Bangladeshi tertiary hospital had higher total parasite burden, estimated by parasitemia and plasma PfHRP2, than uncomplicated malaria patients despite shorter fever duration. This suggests that higher parasite multiplication rates (PMR) contribute to causing the higher biomass found in severe disease. Compared with patients without a history of previous malaria, patients with previous malaria carried a lower parasite biomass with similar fever duration at presentation, suggesting that host immunity reduces the PMR.
Hugh W Kingston, Aniruddha Ghose, Katherine Plewes, Haruhiko Ishioka, Stije J Leopold, Richard J Maude, Sanjib Paul, Benjamas Intharabut, Kamorat Silamut, Charles Woodrow, Nicholas PJ Day, Kesinee Chotivanich, Nicholas M Anstey, Amir Hossain, Nicholas J White, Arjen M Dondorp. (2017). Disease Severity and Effective Parasite Multiplication Rate in Falciparum Malaria. Open Forum Infectious Diseases, 4(4)