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

Objectives: The association between thrombocytopenia and parasite density or disease severity is 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 (PF4) binding to Duffy antigen. This study aimed to evaluate the protective role of platelets in young children who are Duffy antigen -negative, such as those in sub-Saharan Africa. Methods: A zero -inflated negative binomial model was used to relate platelet count and parasite density data collected in a longitudinal birth cohort. Platelet factors were measured by enzyme -linked immunosorbent assay in samples collected from malaria -infected children who participated in a crosssectional study. Results: We described that an increase of 10,0 0 0 platelets/mu l was associated with a 2.76% reduction in parasite count. Increasing levels of PF4 and CXCL7 levels were also significantly associated with a 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. (c) 2023 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY -NC -ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )