How does malaria cause anemia?

Malaria causes anemia primarily through the destruction of red blood cells by Plasmodium parasites.1

During the infection cycle, merozoites—a stage of the parasite—invade red blood cells, where they grow and multiply. This process leads to the rupture and destruction of the infected cells as the next generation of parasites is released into the bloodstream. Because the parasites destroy these cells more rapidly than the bone marrow can replenish them, the total number of red blood cells decreases, resulting in anemia.123

Additionally, the spleen, which is responsible for filtering out degenerate red blood cells, often becomes enlarged during a malaria infection as it works to manage the increased rate of cell destruction. This cycle of infection and rupture is a hallmark of the disease's pathology.12