Trauma-related splenectomy reveals high prevalence of Plasmodium falciparum in asymptomatic individuals in Indonesia, suggesting chronic malaria complications.
Splenic rupture is a recognised complication of acute Plasmodium falciparum and P. 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 parasitaemia 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% [697/1,807]; p<0.0001). Our findings suggest asymptomatic parasitaemia with either P. falciparum or P. vivax is associated with splenic rupture following trauma, pointing towards an additional consequence of chronic infection in malaria-endemic areas.
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