# Chronic Malaria Is Associated With Trauma-related Splenic Rupture Requiring Splenectomy

## TL;DR

Chronic malaria may make the spleen more prone to rupture after trauma, even in the absence of symptoms.

## Contribution

This study identifies chronic asymptomatic malaria as a risk factor for trauma-related splenic rupture.

## Key findings

- Asymptomatic malaria parasitemia was found in 87.9% of trauma-related splenectomy patients.
- This rate was over twice that of the general population in the same region.
- Chronic malaria may increase spleen vulnerability to trauma-induced rupture.

## Abstract

Splenic rupture is a recognized complication of acute Plasmodium falciparum and Plasmodium 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 parasitemia 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% [697/1807]; P < .0001). Our findings suggest asymptomatic parasitemia with either P. falciparum or P. vivax is associated with splenic rupture following trauma, pointing toward an additional consequence of chronic infection in malaria-endemic areas.

Asymptomatic Plasmodium falciparum or P. vivax parasitemia is over twice as frequent in trauma-related splenectomy patients than in the general population in Timika, Indonesia, suggesting that chronic malaria may increase vulnerability to splenic rupture following trauma in malaria-endemic areas.