Chronic Malaria Is Associated With Trauma-related Splenic Rupture Requiring Splenectomy

Splenic rupture is a recognized complication of acute Plasmodium falciparum and Plasmodium vivax malaria, but the risk of splenic rupture in chronic asymptomatic infections is unknown. In Timika, Papua, Indonesia, we determined the proportion of PCR-detectable asymptomatic peripheral parasitemia in patients undergoing trauma-related splenectomy (2015-21) and found it was more than twice the proportion compared to a 2013 household survey of the general population (87.9% [29/33] vs 38.6% [697/1807]; P < .0001). Our findings suggest asymptomatic parasitemia with either P. falciparum or P. vivax is associated with splenic rupture following trauma, pointing toward an additional consequence of chronic infection in malaria-endemic areas.