Ex vivo Microsphiltration Profile of Plasmodium Falciparum Infected Red Blood Cells in Patients with Malaria in Kéniéroba, Mali: Exploring the Spleen Retention Function

Author(s): Bourama Keita, Agnes Guindo, Drissa Konaté, Karim Traoré, Saidou Balam, Bakaina Diarra, Sory Ibrahim Diawara, Ibrahim Sanogo, Modibo Sangaré, Mahamadou Diakité, Seidina Diakité 

P. falciparum- Malaria pathophysiology is still not fully understood. The main mechanisms of the malaria physiopathology involve interactions between host and parasite. Although, the role of the spleen has been mentioned in various clinical forms, supportive clinical evidence is still needed. We conducted a pilot study to determine the impact of the spleen functional statuse in different clinical forms of malaria. Ex vivo microsphiltration was utilized to assess the splenic function in patients received during routine consultation with mild malaria at the Kéniéroba health center, a high malaria endemic area in Mali. A total of 25 patients were enrolled for ex vivo microsphiltration. The spleen was non-palpable (Hackett stage 0) in two patients, palpable with deep inspiration (Hackett stage 1) in 22 patients and without deep inspiration (Hackett stage 2) in one patient. The parasitaemia ranged from 5360 -to 342720 trophozoites/μl with a mean parasitemia of 50774 trophozoites/μl ± 65540 trophozoites/μl. The mean hemoglobin level was 11.2g/dl ± 1.2 [8.7-13.4]. The retention rate of the infected red blood cell ranged from 11.11% to 94.44% with an average of 65.4% ± 23.7%. A higher ex vivo retention rate of infected red blood cells was observed in patients with palpable spleen (p= 0.03). This pilot study proved the feasibility of exploring the spleen filtering function in malaria patients using the ex vivo microsphiltration exploreof the veinous collected red blood cell.