Table 1.
Quantitative Distribution of Parasites Across the Brain and Other Organs Among Patients Who Underwent Autopsy
| Organ, Metric | Cases, No. | Diagnosisa |
||||
|---|---|---|---|---|---|---|
| CM1 | CM2 | SMA | CM3 | Other | ||
| Brain | ||||||
| Parasitized vessels, %b | 99 | 87 (76.6–95.8) | 84.6 (61.4–93.0) | 0.5 (0–2.85) | 0 (0–2.6) | 0 (0–0) |
| Unpigmented parasites, no./100 vessels | 99 | 11 (0–50) | 6.6 (0–102) | 0 (0–2) | 0 (0–0) | 0 (0–0) |
| Pigmented parasites, no./100 vessels | 99 | 201 (147–396) | 202 (47–314) | 0 (0–0.5) | 0 (0–0) | 0 (0–0) |
| Parasites, no./10 HPFc | 99 | 62 (58–102) | 59 (35–84) | 0.1 (0–0.5) | 0 (0–0.5) | 0 (0–0) |
| Heart, parasites, no./10 HPFc | 82 | 42 (2–123) | 14 (5–43) | 18 (0–19) | 0 (0–4) | 0 (0–2) |
| Lung, parasites, no./10 HPFc | 94 | 43 (26–115) | 29 (17–71) | 3 (1–23) | 8 (5–22) | 7 (2–20) |
| Stomach, parasites, no./10 HPFc | 87 | 49 (16–375) | 52 (13–209) | 10 (0–27) | 3 (1–13) | 1 (0–4) |
| Jejunum, parasites, no./10 HPFc | 82 | 93 (22–368) | 87 (31–542) | 27 (11–42) | 18 (4–54) | 0 (0–26) |
| Ileum, parasites, no./10 HPFc | 87 | 86 (3–265) | 51 (13–108) | 11 (2–43) | 11 (1–26) | 2 (0–6) |
| Colon, parasites, no./10 HPFc | 83 | 142 (10–379) | 69 (17–405) | 38 (6–70) | 13 (0–28) | 0 (0–7) |
| Spleen, parasites, no./10 HPFc | 92 | 63 (47–113) | 10 (3–115) | 9 (5–15) | 3 (2–9) | 7 (2–11) |
| Skin, parasites, no./10 HPFc | 48 | 19 (5–138) | 109 (40–316) | 0 (0–2.7) | 0 (0–3) | 0 (0–0) |
| Overalld | … | 488 (217–1237) | 354 (159–1598) | 51 (16–179) | 68 (35–106) | 34 (15–47) |
Data are median (interquartile range), unless otherwise indicated. For all rows, findings from the Kruskal–Wallis test (differences among groups, nonparametric) and the nonparametric trend test (decreasing value from left to right) were highly significant (P ≤ .0001).
Abbreviations: CM1, sequestration only; CM2, sequestration with extravascular pathology; CM3, no sequestration of parasitized red blood cells in the brain, and another cause of death identified; HPF, high-power field; SMA, severe malarial anemia.
a All diagnoses but SMA had ≥6 cases per organ. Indeterminate cases were not used in calculations.
b Out of at least 100 counted vessels.
c Data were calculated by dividing the total number of parasites/100 vessels by 4, which approximates the number of parasites in capillaries per 10 HPF (1000× original magnification; oil immersion). However, because this counting method only includes capillaries, these data underestimate the total number of parasites present in any section.
d Data denote the sum of all counts (per 10 HPF) for each organ, where available. If no count was available, 0 was used. Thus, these data underestimate the true range, because cases with missing organs may be undercounted.