Malarial anaemia: a crossroad?

Despite the apparent frailty of a complex cycle, Plasmodium falciparum seems remarkably fit in its ability to escape human interventions. The red blood cell is central in a number of aspects of the cycle. Hence, hematocrit reduction is of paramount importance in vector survival and reproduction, gametocyte induction and infectiousness, and host pathology. Here, in the light of recent observations, the importance of anemia for P. falciparum is emphasized, suggesting that among populations at risk for malaria, the subgroup of anemic patients may be preferential amplifiers of the plasmodial cycle.