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Updated: Nov 4, 2025
Intravital Microscopy of the Spleen: Quantitative Analysis of Parasite Mobility and Blood Flow
Published on: January 14, 2012
Ultrasonographic Hepatosplenic Parenchymal and Blood Flow Changes in Children with Acute Falciparum Malaria
O M Atalabi1, A J Adekanmi1, A E Orimadegun2
1Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
Insights
Pediatric malaria in Nigeria significantly impacts spleen and liver size and blood flow. Higher parasite density correlates with increased spleen and liver dimensions and altered blood flow indices.
Area of Science:
- Pediatric Infectious Diseases
- Medical Imaging
- Hepatology and Splenology
Background:
- Malaria is a leading cause of illness and death in Nigerian children.
- Acute malaria presents with biochemical, hematological, and multiorgan changes, notably affecting the spleen and liver.
Purpose of the Study:
- To investigate hepatosplenic pathologies in Nigerian children with acute Plasmodium falciparum malaria.
- To assess changes in spleen and liver size and blood flow dynamics.
Main Methods:
- A prospective case-control study involved 260 children (6 months to 6 years): 65 uncomplicated malaria (UCM), 65 complicated malaria (CM), and 130 controls.
- Laboratory tests and ultrasonographic evaluation of hepatosplenic parenchyma and blood flow were performed.
Main Results:
- Complicated malaria (CM) showed significantly larger mean splenic length compared to uncomplicated malaria (UCM).
- Liver span differed significantly between controls and CM, and between controls and UCM groups.
- Portal vein and splenic artery flow velocities were reduced in malaria cases compared to controls, with correlations between malaria parasite density and spleen/liver dimensions and vascular indices.
Conclusions:
- Acute malaria in children is associated with reduced splenic and portal vein blood flow velocities.
- Higher malaria parasite density directly correlates with increased spleen and liver span, and altered splenic artery and portal vein indices.
Background:
Malaria, a major cause of morbidity and mortality in Nigerian children, is associated with biochemical, haematological, blood flow and clinical multiorgan changes, including changes in the spleen and the liver.
Objectives:
To investigate hepatosplenic pathologies in a Nigerian children cohort with acute P. falciparum malaria.
Methods:
A prospective case-control study of 260 children (65 uncomplicated malaria (UCM),65 complicated malaria (CM) cases and 130 controls) aged six months to six years. All subjects had laboratory tests and hepatosplenic parenchymal and blood-flow ultrasonographic evaluation.
Results:
Mean splenic length was 8.13cm (95% CI: 7.84cm, 8.41cm) and 7.42cm (95% CI: 7.13cm, 7.71cm) in CM and UCM (p=0.001) respectively, liver span was significantly different in controls and CM (p<0.001); controls and UCM (p=0.014). Portal vein flow velocity was 32.5cm/s, 25.4cm/s and 26.5cm/s in controls, UCM and CM (p=<0.001 and 0.004 respectively) while splenic flow velocity was 30.7cm/s and 25.8cm/s in controls and CM (p=0.022). Splenic artery peak systolic velocity (PSV) =73.78cm/s, 66.52cm/s and 59.35cm/s (p = 0.008) among controls, UCM and CM respectively. There was significant correlation between malaria parasite (MP) density and splenic length (r =0.239, p = 0.007), splenic artery pulsatility index (PI) (r = 0.300, p = 0.001), splenic artery resistivity index (RI) (r = 0.260, p = 0.003) and liver span.
Conclusion:
In children with acute malaria, the splenic vessels and portal vein blood flow velocities were reduced. High malaria parasite density evokes direct relationship with spleen and liver span, splenic artery RI and PI and portalvein diameter.
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