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While decades of research have led to improved survival for <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> patients in wealthy countries, survival remains dismal in low\u2010 and middle\u2010income countries. Much of the early mortality associated with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> is attributed to increased risk of infections due to early loss of splenic function. In the West, bacterial infections with encapsulated organisms are a primary concern. In sub\u2010Saharan Africa, where the majority of infants with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> are born, the same is true. However malaria presents an additional threat to survival. The search for factors that define variability in sickle cell phenotypes should include environmental modifiers, such as malaria. Further exploration of this relationship could lead to novel strategies to reduce morbidity and mortality attributable to infections. In this review, we explore the interactions between <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content>, malaria and the spleen to better understand how splenomegaly and splenic (dys)function may co\u2010exist in patients with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> living in malaria\u2010endemic areas.<\/jats:p>","DOI":"10.1111\/bjh.14592","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T15:22:32Z","timestamp":1494516152000},"page":"938-946","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Turf wars: exploring splenomegaly in sickle cell disease in malaria\u2010endemic regions"],"prefix":"10.1111","volume":"177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5973-8507","authenticated-orcid":false,"given":"Ven\u00e9e N.","family":"Tubman","sequence":"first","affiliation":[{"name":"Texas Children's Cancer and Hematology Centers 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