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To the Editor: Malaria remains a major problem of public health in developing countries and is responsible for more than 1 million deaths each year.¹ Life-threatening malaria is predominantly a result of Plasmodium falciparum infection, and central nervous system involvement, ie, "cerebral malaria," is observed in approximately 1% of P falciparum infections and is a major cause of death. In P falciparum malaria, parasitized erythrocytes sequester in capillary beds through adhesion to vascular endothelium, a process that occurs predominantly in deep tissues not amenable to direct examination.² Activation of microvascular endothelium in a variety of disease states causes the release of endothelial microparticles (EMPs) into the circulation.³ Plasma concentrations of tumor necrosis factor (TNF) are increased in patients with malaria,² and TNF can induce the release of procoagulant and proadhesive microparticles from cultured endothelial cells in vitro.³ Numbers of EMPs in peripheral blood may therefore serve as a marker of . . . [Full Text of this Article]

Methods

Valéry Combes, PhD
Experimental Parasitology Unit
Faculty of Medicine
Université de la Méditerranée
Marseille, France

Terrie E. Taylor, DO
Malawi-Liverpool-Wellcome Trust Clinical Research Programme and Blantyre Malaria Project
Blantyre, Malawi

Irène Juhan-Vague, MD, PhD
Haematology Laboratory
Faculty of Medicine
Université de la Méditerranée

Jean-Louis Mège, MD, PhD
Rickettsia Unit
Faculty of Medicine
Université de la Méditerranée

James Mwenechanya, MB; Madalitso Tembo, MB
Malawi-Liverpool-Wellcome Trust Clinical Research Programme and Blantyre Malaria Project

Georges E. Grau, MD, PhD
georges.grau@medecine.univ-mrs.fr
Experimental Parasitology Unit
Faculty of Medicine
Université de la Méditerranée

Malcolm E. Molyneux, MD, FRCP
Malawi-Liverpool-Wellcome Trust Clinical Research Programme and Blantyre Malaria Project

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ABSTRACT | FULL TEXT