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

Malaria pathophysiology is not still fully understood. The main mechanisms of malaria involve the synergistic interactions between host and parasite. Although, the role of the spleen has been mentioned in various clinical forms of malaria, a supportive clinical evidence is still needed. We conducted a pilot study to determine the impact of the spleen functional state in different clinical forms of malaria.Ex vivo microsphiltration was used to assess the splenic function in patients received during routine consultation with malaria at the Kéniéroba health center, a ​​high malaria endemic area in Mali.A total of 25 patients were enrolled for microsphiltration. Two patients (8%) had a no palpable spleen (Hackett stage 0), 22 patients (88%) had a palpable spleen with at deep inspiration (Hackett stage 1) and only one patient (4%) presented a palpable spleen (Hackett stage 2). Parasitaemia ranged from 5360 trophozoites/µl to 342720 trophozoites/µl with a mean parasitemia of 50774 trophozoites/µl ± 65540 trophozoites/µl; the mean hemoglobin rate was 11.2 ± 1.2 g/dl with the extremes of 8.7 g/dl and 13.4 g/dl. 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 Hackett stages greater than or equal to 1 (p= 0.03). This pilot study proved the feasibility of the exploration of the spleen filtering function in malaria patients using the ex vivo microsphiltration.