The anemia associated with human malaria cannot be completely explained by increased hemolysis. Depression of erythropoiesis associated with parasitemia has been suggested as an additional aggravating factor. This suggestion is supported by the following clinical evidence: (1) absence of reticulocytosis during malarial infection in which hemolysis was observed 1-3 and (2) a decreased number of erythroid precursors in the bone marrow during acute primary infection, followed by a normal or increased number of these cells after the removal of the parasites from the blood.3 Although the latter study3 has clearly demonstrated a depression of erythropoiesis during acute primary malarial infection, the situation is less clear in chronic or secondary malaria where normal or increased numbers of erythroid precursors are found in the bone marrow during parasitemia. Furthermore, the mechanism of erythropoietic depression remains unsolved.
Further investigation into the effect of human malaria on bonemarrow function was carried out