Assessing the burden and improving the diagnosis and clinical management of hyperreactive malarial splenomegaly patients in Northwest Ethiopia

Hyperreactive malarial splenomegaly syndrome (HMS), is characterized by persistent splenomegaly and hematologic abnormalities such as pancytopenia. The disease is linked to prolonged malaria exposure, genetic predispositions, and factors like pregnancy and poor nutrition. There is no reliable data on the burden of the disease, and the ongoing problem in Ethiopia underscores the need to improve the diagnostic challenges and treatment strategies: there is neither a confirmatory diagnostic test nor an effective treatment strategy established in Ethiopia. Many countries including Ethiopia still use chloroquine for treatment and prophylaxis, but whether this is currently still effective has not been documented. This proposal aims to characterize the features of HMS and develop a diagnostic and therapeutic algorithm to enhance diagnosis and treatment in Ethiopia.

The research will be conducted at the University of Gondar Hospital, incorporating a cohort of HMS patients identified through various health centers. A comprehensive assessment including clinical evaluations, laboratory tests, and immunological analyses will be conducted. The study will utilize and evaluate the revised Fakunle’s diagnostic criteria and try to develop an improved diagnostic algorithm based on collected data. The outcome of chloroquine suppressive treatment will be evaluated.

The study is expected to provide detailed descriptions of HMS clinical and laboratory characteristics, evaluate treatment outcomes with chloroquine, and identify factors affecting treatment response.