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New Perspectives for Adjuvant Therapy in Severe Malaria

Mauro Prato and Giuliana Giribaldi

Malaria is one of the most common parasitic diseases in the world, leading to over 1 million deaths/year. It mainly affects children under 5 years of age and pregnant women and can be fatal. The most virulent among the human malaria parasites is Plasmodium falciparum (Pf), which is responsible for the bulk of the malaria-related morbidity and mortality. Symptoms of uncomplicated malaria include fever, headache and vomiting, whereas the major complications of severe malaria include Cerebral Malaria (CM), pulmonary edema, acute renal failure or severe anaemia. It is characterized by the binding of Infected Red Blood Cell (IRBC) to the vascular endothelium (cytoadherence) and to non-infected erythrocytes (rosetting). The accumulation of IRBC and non-infected RBC generates a reduction in the blood flow of the microvasculature, which results in tissue hypoxia and necrosis.

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