Higher platelet counts and platelet factors are associated with a reduction in Plasmodium falciparum parasite density in young Malian children.

INTRODUCTION: The association between thrombocytopenia and parasite density or disease severity are described in numerous studies. In recent years, several studies described the protective role of platelets in directly killing Plasmodium parasites, mediated by platelet factor 4 binding to Duffy antigen.

OBJECTIVE: To evaluate the protective role of platelets in young children that are Duffy antigen-negative, such as those in sub-Saharan Africa.

METHODS: A zero-inflated negative binomial (ZINB) model was used to relate platelet count and parasite density data collected in a longitudinal birth cohort. Platelet factors were measured by ELISA in samples collected from malaria-infected children participated in a cross-sectional study.

RESULTS: We described that an increase of 10,000 platelets/μl was associated with a 2.76% reduction in parasite count. Increasing levels of platelet factor 4 and CXCL7 levels were also significantly associated with reduction in parasite count.

CONCLUSIONS: Platelets play a protective role in reducing parasite burden in Duffy-negative children, possibly mediated through activation of the innate immune system.