Park GS, et al. – Plasma P. falciparum histidine–rich protein–2 (PfHRP2) concentrations distinguish retinopathy positive (RP) from retinopathy negative (RN) cerebral malaria (CM). Researchers sought to compare PfHRP2 concentrations between RN CM and other forms of severe malaria or asymptomatic parasitemia (AP). Findings revealed higher PfHRP2 concentrations in children with RN CM than in children with severe malarial anemia (SMA) or AP, indicating the involvement of P. falciparum in disease pathogenesis in children with CM. PfHRP2 concentrations seemed to provide a more feasible and consistent assessment of the contribution of P. falciparum to severe disease than malaria retinopathy.

Methods

• Researchers performed a comparison of plasma PfHRP2 concentrations in 260 children with CM (247 examined for retinopathy), 228 children with severe malarial anemia (SMA) and 30 community children with AP.

Results

• Higher PfHRP2 concentrations were observed in children with RP CM than RN CM (P=0.006), with an area under the receiver operating characteristic curve (AUROC) of 0.61 [95% confidence interval, 0.53–0.68].
• In RN CM, PfHRP2 concentrations and sequestered parasite biomass were higher in comparison to SMA (both P<0.03) or AP (both P<0.001).