In 2016, malaria caused nearly half a million deaths, mostly in children. New research could help reduce the associated mortality thanks to a computer analysis that describes a new clinical phenotype of this disease.

There are more clinical phenotypes of severe malaria than those defined by the World Health Organization (WHO), according to a study led by ISGlobal. The results indicate that heart failure can be a pathogenic mechanism in severe malaria, which would have implications in the clinical management of this type of patients.

Despite the achievements made in recent decades, it is estimated that in 2016 malaria caused nearly half a million deaths, mostly in children. The definition of severe malaria was established to identify those children at greater risk of dying, but in reality it is a complex and heterogeneous disease that does not always respond to the indicated treatments.

The team led by Climent Casals-Pascual, researcher at ISGlobal and the University of Oxford, applied a network-based computer analysis to identify biologically relevant phenotypes different from the three types currently defined by WHO (cerebral malaria, respiratory distress and anemia due to severe malaria).

To do this, they conducted a ‘network-based group analysis’ using clinical data from almost 3,000 Gambian children hospitalized for malaria. They found that mortality is higher in groups with more heterogeneous phenotypes.

In addition, they identified four groups (or clusters) of patients with respiratory distress and severe anemia in whom the increase in liver size was associated with increased mortality. The analysis of proteins in the plasma of these patients revealed that this is probably due to deficiencies in cardiac function.

“Our results indicate that heart failure should be considered again as a pathogenic mechanism in severe malaria,” explains Casals-Pascual, “and the standard treatment may be inappropriate for these patients.”

This type of systems approach based on clinical manifestations “can be very useful to identify new phenotypes and mechanisms, and therefore better therapeutic options for complex diseases”, adds the researcher.

 

Source: SINC