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Antwi-Baffour S, Mensah BT, Ahiakonu SA, Armah DNO, Ali-Mustapha S, Annison L. Evaluation of immunophenotypic alterations of peripheral blood lymphocytes and their sub-sets in uncomplicated P. Falciparum infection. BMC Immunol 2024; 25:44. [PMID: 38987710 PMCID: PMC11234552 DOI: 10.1186/s12865-024-00638-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/28/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Malaria is a life-threatening parasitic disease typically transmitted through the bite of an infected Anopheles mosquito. There is ample evidence showing the potential of malaria infection to affect the counts of lymphocyte subpopulations in the peripheral blood, but the extent of alteration might not be consistent in all geographical locations, due to several local factors. Although Ghana is among the malaria-endemic countries, there is currently no available data on the level of alterations that occur in the counts of lymphocyte subpopulations during P. falciparum malaria infection among adults. AIM The study was to determine the immunophenotypic alterations in the level of peripheral blood lymphocytes and their subsets in adults with uncomplicated P. falciparum malaria infection and apparently healthy participants. METHODS The study was a cross-sectional comparative study conducted in two municipalities of the Volta region of Ghana. Blood samples were collected from study participants and taken through serology (P. falciparum/Pan Rapid Diagnostic Kits), microscopy (Thick and thin blood films) and Haematological (Flow cytometric and Full blood count) analysis. RESULTS A total of 414 participants, comprising 214 patients with malaria and 200 apparently healthy individuals (controls) were recruited into this study. Parasite density of the malaria patients ranged from 75/µL to 84,364/µL, with a mean of 3,520/µL. It was also observed that the total lymphocytes slightly decreased in the P. falciparum-infected individuals (Mean ± SD: 2.08 ± 4.93 × 109/L) compared to the control group (Mean ± SD: 2.47 ± 0.80 × 109/L). Again, there was a significant moderate positive correlation between parasite density and haematocrit levels (r = 0.321, p < 0.001). Apart from CD45 + T-cells, more people in the control group had normal values for the lymphocyte subsets measured compared to the malaria patients. CONCLUSIONS From the results obtained, there was high parasite density among the malaria patients suggestive of high intensity of infection in the case group. The malaria patients again showed considerable haematological alterations in lymphocyte sub-sets and the parasite density appeared to be strongly associated with CD4 + T-cell reduction. Also, the parasite density significantly associated with decreasing haematocrit levels. This indicates that lymphocyte subset enumeration can be used to effectively support malaria diagnosis.
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Affiliation(s)
- Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, P. O. Box KB 143, Accra, Ghana.
| | - Benjamin Tetteh Mensah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, P. O. Box KB 143, Accra, Ghana
| | - Simon Aglona Ahiakonu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, P. O. Box KB 143, Accra, Ghana
| | - Dorinda Naa Okailey Armah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, P. O. Box KB 143, Accra, Ghana
| | - Samira Ali-Mustapha
- Department of Maternal and Child Health, School of Nursing, University of Ghana, Legon, Ghana
| | - Lawrence Annison
- Department of Medical Laboratory Technology, School of Medical Sciences, Accra Technical University, Accra, Ghana
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Orish VN, Lokpo SY, Kwadzokpui PK, Safianu R, Marinkovic A, Prakash S, Okorie C, Izurieta R, Pandit R, Sanyaolu A. Association between asymptomatic Plasmodium falciparum malaria infection, anaemia and mean corpuscular volume of school children in the Volta Region of Ghana. Eur J Microbiol Immunol (Bp) 2024; 14:195-201. [PMID: 38407577 PMCID: PMC11097786 DOI: 10.1556/1886.2024.00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Background Although, several studies have reported abnormal Mean Corpuscular Volume (MCV) values and anaemia associated with malaria infections with a focus on Plasmodium falciparum among patients with complicated and uncomplicated malaria, none has looked at the association with asymptomatic malaria. This study aimed to assess this association. Methods We conducted a cross-sectional study using 3 mL of blood samples from 549 children aged 5-17 years attending 5 schools selected in the Volta Region. Semi-structured questionnaires were administered to the children to obtain demographic data. Blood samples were collected to estimate the children's full blood count (FBC) and malaria status. Data obtained were analysed using STATA 15 software. P-values of less than 0.05 were considered statistically significant. Results Most of the children in this study (49.9%) had normal MCV (81.3-91.3 fL) with an overall malaria prevalence of 55.6 % (95% CI: 51.3-59.8) and anaemia prevalence of 48.6% (95% CI 44.4-52.9). Most anaemic children had normal MCV (81.3-91.3 fL) (49.8, 95% CI 43.7-56.0). The predicted probability of malaria was highly likely among children with normal MCV (81.3-91.3 fL) but with high variability and uncertainty among those with low MCV (<81.3 fL) and high MCV (>91.3 fL). Conclusion This study shows a reduced predicted probability of malaria among children with low and high MCV, playing a protective function against malaria. Further studies are required to elucidate the interaction.
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Affiliation(s)
- Verner N. Orish
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Sylvester Y. Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Rufai Safianu
- Department of Basic Medical Sciences, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | | | | | - Chuku Okorie
- Union County College (Plainfield Campus), Plainfield, NJ, USA
| | - Ricardo Izurieta
- Global Communicable Diseases, College of Public Health, University of South Florida, Tampa, FL, USA
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Tiiba JDI, Ahmadu PU, Naamawu A, Fuseini M, Raymond A, Osei-Amoah E, Bobrtaa PC, Bacheyie PP, Abdulai MA, Alidu I, Alhassan A, Abdul Hamid JG, Yussif A, Tayawn PT, Sakyi AA, Yeng TN, Aziz SA, Mankana AH, Husein WA, Abdallah AKW, Mwininyaabu KS, Kuffour MO, Boateng EO, Owusu-Achiaw B, Eyulaku NJ. Thrombocytopenia a predictor of malaria: how far? J Parasit Dis 2023; 47:1-11. [PMID: 37187502 PMCID: PMC9998753 DOI: 10.1007/s12639-022-01557-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Malaria is an acute febrile illness. It is a dangerous disease that contributes to millions of hospital visits and hundreds of thousands of deaths, especially in children residing in sub-Saharan Africa. In a non-immune individual, symptoms usually appear 10-15 days after the infective mosquito bite. The first symptoms-fever, headache, and chills-may be mild and difficult to recognize as malaria. If not treated within 24 h, P. falciparum malaria can progress to severe illness, often leading to death. Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ involvement is also frequent. In malaria endemic areas, people may develop partial immunity, allowing asymptomatic infections to occur. Haematological changes are well-recognised with malarial infection however background haemoglobinopathy, nutritional status, demographic factors and malaria immunity play a major role in specific changes in that geographical region. Artemisinin derivatives are new generation antimalarial drugs they are used in the treatment of acute attacks of severe malaria including cerebral malaria. Information on the safety of these new antimalarial drugs on body function is still scanty. Haematological parameters are well studied in P. falciparum infection, but now recent studies have indicated that these changes do occur in P. vivax infection also. Hematological profile together with microscopy will enable rapid diagnosis, prompt treatment and further complications can be avoided. This current review is aimed at providing an up-to-date information on the role of malaria and anti-malarial drugs on haematological parameters especially thrombocytopenia.
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Affiliation(s)
- Jamal-Deen I. Tiiba
- Pharmacology Department, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Peter Uchogu Ahmadu
- Pharmacology and Toxicology Department, National Institute for Pharmaceutical Research and Development, Abuja, Nigeria
| | | | | | - Anecham Raymond
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
| | | | | | | | | | - Issah Alidu
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
| | - Ahmed Alhassan
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
| | | | - Abukari Yussif
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
| | | | | | - Titus Naa Yeng
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
| | - Sanda A. Aziz
- Laboratory Department, Tamale Teaching Hospital, Tamale, Ghana
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Aghahowa S, Ozolua R, Bafor E, Obarisiagbon P, Isah A. Toxicological effect of Artemisinin-Based Combination Therapies plus Paracetamol in malaria patients. Toxicol Rep 2021; 8:1930-1936. [PMID: 34926171 PMCID: PMC8649067 DOI: 10.1016/j.toxrep.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/27/2021] [Accepted: 11/04/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Following the paucity of safety reports in the use of Artemisinin-Based Combination Therapies (ACTs) plus paracetamol, the study assessed safety potential of artemether-lumefantrine (ALP), artesunate-amodiaquine (AAP), artesunate-mefloquine (AMP), artesunate-sulphadoxine-pyrimethamine (ASPP) and dihydroartemisinin-piperaquine (DHPP) combination with paracetamol in malaria patients. METHODS ACTs and paracetamol were administered concomitantly in conventional doses/regimen to randomly selected patients. Blood samples were collected from the ante-cubital vein before and after completion of therapies. Toxicity markers such as weights, glucose, lipids, renal electrolytes, liver enzymes and haematological indices were assessed using standard protocols. RESULTS The total numbers of participants were 57 patients. Male to female ratio was 1:1.1. Mean body weight and ages were 59.19 ± 1.39 kg and 42.86 ± 1.32 years respectively. The mean temperatures prior to and after therapy were 37.49 ± 1.02 °C and 37.50 ± 0.17 °C respectively. Mean parasitaemia before the commencement of therapy was 6282 ± 21.01 parasites/μl. Out of thirty-seven toxicological indices evaluated, twenty-four were significantly altered by ACTs plus paracetamol (P < 0.05). Increased serum toxicity markers due to the drug combinations were glucose (AAP, AMP), urea (ALP, ASPP), bicarbonate ion (ALP, AAP, AMP, ASPP), chloride ion (ALP, AAP, AMP), creatinine (ALP, AAP, AMP, ASPP), alkaline phosphatase (ALP, AAP), aspartate aminotransferase and alanine aminotransferase (ALP, AAP, AMP, ASPP, DHPP), total protein (AMP, DHPP) and albumin (AMP, DHPP). Decreased serum toxicity markers due to the drugs were glucose (ALP, ASPP, DHPP), urea (AMP), bicarbonate ion (DHPP), chloride ion (ASPP, DHPP), creatinine (DHPP), alkaline phosphatase (AMP, ASPP, DHPP), total protein (ALP, AAP, and ASPP) and albumin (ALP, AAP, ASPP). Altered haematological indices were white blood cells, red blood cells, mean cell haemoglobin and platelets. CONCLUSION Since ACTs plus paracetamol altered human system, discrete selection is essential in managing uncomplicated malaria most especially in patients with co-morbid conditions.
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Affiliation(s)
- S.E. Aghahowa
- Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria
| | - R.I. Ozolua
- Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria
| | - E.E. Bafor
- Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria
| | - P. Obarisiagbon
- Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria
| | - A.O. Isah
- College of Medicine, University of Benin, Benin City, Nigeria
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Bayleyegn B, Asrie F, Yalew A, Woldu B. Role of Platelet Indices as a Potential Marker for Malaria Severity. J Parasitol Res 2021; 2021:5531091. [PMID: 37601293 PMCID: PMC10435314 DOI: 10.1155/2021/5531091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 08/22/2023] Open
Abstract
Purpose Platelet parameter alteration such as platelet count and platelet indices are more common than in other blood cell lines due to diverse causative pathophysiological mechanisms in severe malaria infection. In malaria patients, no more studies evaluated platelet indices in relation to disease severity and prognosis. Therefore, this review assessed the current scientific knowledge on the potential role of platelet indices for the diagnostic marker of severe malaria infection. Results Hence, after reviewing recent literatures, elevation of mean platelet volume and platelet distribution width in addition to decreased plateletcrit and platelet counts is the known potential risk factor associated with warning signs of severe malaria. Thus, thrombocytopenia < 150 × 109/L, MPV ≥ 9.05 fL, and PDW ≥ 14.550% as well as significantly higher P-LCR and decrease in PCT are shown significant sensitivity and specificity as they are used as diagnostic and prognostic values in severe malaria infection. Conclusion Platelet indices are useful predictors of malaria severity. Immature platelet fraction (IPF%) is raised in the case of severe malaria, and it was significantly more useful than MPV. Advanced research will further investigate the platelet index abnormality associated with specific age and gender among specific malaria species.
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Affiliation(s)
- Biruk Bayleyegn
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Berhanu Woldu
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Jiero S, Pasaribu AP. Haematological profile of children with malaria in Sorong, West Papua, Indonesia. Malar J 2021; 20:126. [PMID: 33663524 PMCID: PMC7931533 DOI: 10.1186/s12936-021-03638-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.
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Affiliation(s)
- Syilvia Jiero
- Department of Child Health, Sorong Regional General Hospital, Sorong, West Papua, Indonesia
| | - Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Dr. Mansur Street No. 5, 20156, Medan, Indonesia.
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Morang'a CM, Amenga-Etego L, Bah SY, Appiah V, Amuzu DSY, Amoako N, Abugri J, Oduro AR, Cunnington AJ, Awandare GA, Otto TD. Machine learning approaches classify clinical malaria outcomes based on haematological parameters. BMC Med 2020; 18:375. [PMID: 33250058 PMCID: PMC7702702 DOI: 10.1186/s12916-020-01823-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Malaria is still a major global health burden, with more than 3.2 billion people in 91 countries remaining at risk of the disease. Accurately distinguishing malaria from other diseases, especially uncomplicated malaria (UM) from non-malarial infections (nMI), remains a challenge. Furthermore, the success of rapid diagnostic tests (RDTs) is threatened by Pfhrp2/3 deletions and decreased sensitivity at low parasitaemia. Analysis of haematological indices can be used to support the identification of possible malaria cases for further diagnosis, especially in travellers returning from endemic areas. As a new application for precision medicine, we aimed to evaluate machine learning (ML) approaches that can accurately classify nMI, UM, and severe malaria (SM) using haematological parameters. METHODS We obtained haematological data from 2,207 participants collected in Ghana: nMI (n = 978), SM (n = 526), and UM (n = 703). Six different ML approaches were tested, to select the best approach. An artificial neural network (ANN) with three hidden layers was used for multi-classification of UM, SM, and uMI. Binary classifiers were developed to further identify the parameters that can distinguish UM or SM from nMI. Local interpretable model-agnostic explanations (LIME) were used to explain the binary classifiers. RESULTS The multi-classification model had greater than 85% training and testing accuracy to distinguish clinical malaria from nMI. To distinguish UM from nMI, our approach identified platelet counts, red blood cell (RBC) counts, lymphocyte counts, and percentages as the top classifiers of UM with 0.801 test accuracy (AUC = 0.866 and F1 score = 0.747). To distinguish SM from nMI, the classifier had a test accuracy of 0.96 (AUC = 0.983 and F1 score = 0.944) with mean platelet volume and mean cell volume being the unique classifiers of SM. Random forest was used to confirm the classifications, and it showed that platelet and RBC counts were the major classifiers of UM, regardless of possible confounders such as patient age and sampling location. CONCLUSION The study provides proof of concept methods that classify UM and SM from nMI, showing that the ML approach is a feasible tool for clinical decision support. In the future, ML approaches could be incorporated into clinical decision-support algorithms for the diagnosis of acute febrile illness and monitoring response to acute SM treatment particularly in endemic settings.
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Affiliation(s)
- Collins M Morang'a
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Lucas Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana.
| | - Saikou Y Bah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana.,Florey Institute, Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK
| | - Vincent Appiah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Dominic S Y Amuzu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Nicholas Amoako
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - James Abugri
- Department of Applied Chemistry and Biochemistry, C. K Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Abraham R Oduro
- Ministry of Health, Navrongo Health Research Centre (NHRC), Navrongo, Ghana
| | - Aubrey J Cunnington
- Section of Pediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Thomas D Otto
- Institute of Infection, Immunity & Inflammation, MVLS, University of Glasgow, Glasgow, UK.
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Punnath K, Dayanand KK, Chandrashekar VN, Achur RN, Kakkilaya SB, Ghosh SK, Mukhi B, Midya V, Kumari SN, Gowda DC. Clinical features and haematological parameters among malaria patients in Mangaluru city area in the southwestern coastal region of India. Parasitol Res 2019; 119:1043-1056. [PMID: 31754856 DOI: 10.1007/s00436-019-06540-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/05/2019] [Indexed: 12/15/2022]
Abstract
The aim of this study was to assess the clinical profile, severity and complications of patients suffering from malaria in Mangaluru, a southwestern coastal city in India. A total of 579 patients, who were treated at the District Wenlock Hospital, Mangaluru, and 168 healthy controls were recruited in this study. The clinical profile, haematological and biochemical parameters, and disease complications were assessed. The majority of patients were treated as outpatients and patients who had severe clinical conditions were admitted to the hospital for treatment and supportive care. Among the total 579 patients recruited in this study, the distribution of P. vivax, P. falciparum and mixed infections were 364 (62.9%), 150 (25.9%) and 65 (11.2%), respectively. Among these, 506 (87.4%) had mild malaria, whereas 73 (12.6%) had severe malaria. Overall, the clinical features and severity of malaria in P. vivax and mixed infection patients were comparable to P. falciparum patients, albeit with some significant differences. The clinical complications in severe malaria cases included thrombocytopenia (50.7%), metabolic acidosis (30.1%), severe anaemia (26.0%), jaundice (21.9%), hepatic dysfunction (15.1%), acute renal failure (6.8%), haematuria (8.2%), hypotension (9.6%), cerebral malaria (1.4%) and acute respiratory distress syndrome (1.4%). All the patients with severe malaria recruited in our study were successfully treated and discharged. Majority of patients had mild malaria, likely due to seeking treatment soon after experiencing symptoms and/or having preexisting immune protection. However, a significant number of patients had severe malaria and required hospital admission indicating that there is a substantial need for creating awareness among vulnerable immigrant population. Implementing effective surveillance and vector control measures in malaria hotspot locations in the city and educating people about preventive measures are likely to reduce the malaria burden in this endemic region.
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Affiliation(s)
- Kishore Punnath
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka, India
| | - Kiran K Dayanand
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka, India
| | - Valleesha N Chandrashekar
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka, India
| | - Rajeshwara N Achur
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka, India.
| | | | - Susanta K Ghosh
- Department of Molecular Parasitology, ICMR-National Institute of Malaria Research, Poojanahalli, Bangalore, India
| | - Benudhar Mukhi
- Department of Molecular Parasitology, ICMR-National Institute of Malaria Research, Poojanahalli, Bangalore, India
| | - Vishal Midya
- Department of Biostatistics and Bioinformatics, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Suchetha N Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
| | - D Channe Gowda
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA, USA.
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Thiam A, Baaklini S, Mbengue B, Nisar S, Diarra M, Marquet S, Fall MM, Sanka M, Thiam F, Diallo RN, Torres M, Dieye A, Rihet P. NCR3 polymorphism, haematological parameters, and severe malaria in Senegalese patients. PeerJ 2018; 6:e6048. [PMID: 30533319 PMCID: PMC6282937 DOI: 10.7717/peerj.6048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
Background Host factors, including host genetic variation, have been shown to influence the outcome of Plasmodium falciparum infection. Genome-wide linkage studies have mapped mild malaria resistance genes on chromosome 6p21, whereas NCR3-412 polymorphism (rs2736191) lying within this region was found to be associated with mild malaria. Methods Blood samples were taken from 188 Plasmodium falciparum malaria patients (76 mild malaria patients, 85 cerebral malaria patients, and 27 severe non-cerebral malaria patients). NCR3-412 (rs2736191) was analysed by sequencing, and haematological parameters were measured. Finally, their association with clinical phenotypes was assessed. Results We evidenced an association of thrombocytopenia with both cerebral malaria and severe non-cerebral malaria, and of an association of high leukocyte count with cerebral malaria. Additionally, we found no association of NCR3-412 with either cerebral malaria, severe non-cerebral malaria, or severe malaria after grouping cerebral malaria and severe non-cerebral malaria patients. Conclusions Our results suggest that NCR3 genetic variation has no effect, or only a small effect on the occurrence of severe malaria, although it has been strongly associated with mild malaria. We discuss the biological meaning of these results. Besides, we confirmed the association of thrombocytopenia and high leukocyte count with severe malaria phenotypes.
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Affiliation(s)
- Alassane Thiam
- Unité d'Immunogénétique, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Babacar Mbengue
- Service d'Immunologie, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Samia Nisar
- Aix Marseille Univ, INSERM, TAGC, Marseille, France
| | - Maryam Diarra
- G4 Biostatistique, Institut Pasteur de Dakar, Dakar, Sénégal
| | | | | | - Michel Sanka
- Aix Marseille Univ, INSERM, TAGC, Marseille, France
| | - Fatou Thiam
- Unité d'Immunogénétique, Institut Pasteur de Dakar, Dakar, Senegal
| | | | | | - Alioune Dieye
- Unité d'Immunogénétique, Institut Pasteur de Dakar, Dakar, Senegal.,Service d'Immunologie, University Cheikh Anta Diop of Dakar, Dakar, Senegal
| | - Pascal Rihet
- Aix Marseille Univ, INSERM, TAGC, Marseille, France
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10
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Nedaei F, Noormohammadi Z, Naddaf SR, Mohammadi S, Esmaeili Rastaghi AR. Analysis of Plasmodium vivax Apical Membrane Antigen-1 (PvAMA-1) Haplotypes among Iranian Isolates. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2017; 6:222-234. [PMID: 29988191 PMCID: PMC6004292 DOI: 10.22088/bums.6.4.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/11/2017] [Indexed: 11/18/2022]
Abstract
Plasmodium vivax apical membrane antigen-1(PvAMA-1) is a surface protein with polymorphic sites. This study was aimed to analyze the polymorphic amino acid residues at PvAMA-1 in different infected age groups. 92 blood samples were collected from the south and southeast of Iran. The DNA coding for the domain I (DI), DII, and partial DIII of this antigen was amplified by Nested-PCR, and sequenced. Nucleotide mutations were found in 49 sites and based on the amino acid sequence, 30 variable sites were detected. Age distribution of malaria cases showed that the majority of the patients were between 10 to 30 years old. The scattering plot haplotypes by age showed an increasing incidence rate with age during childhood, whereas, incidence was the lowest in patients under five years old. Comparison of the polymorphic sites of PvAMA-1 in Iranian isolates with those found in other geographic regions of the world indicated nine common variable positions. In addition, a significant dependence was found between some particular substitutions and age categories. Dependence between particular substitutions and age groups suggests that certain residues in AMA-1 are responsible for clinical attacks in different ages, likely as a result of host immune pressure. The crystal structure of the PvAMA-1 showed that the amino acid substitutions that changed the protein charge were exclusively located in loops and turns where, the interactions with antibodies could occur. These data provide the necessary information for an AMA-1 based malaria vaccine design to be effective across all ages.
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Affiliation(s)
- Fatemeh Nedaei
- Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran
| | - Zahra Noormohammadi
- Department of Biology , College of Basic Science Islamic Azad University, Science and Research Branch, Tehran, Iran
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11
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A Ali E, M Abdalla T, Adam I. Platelet distribution width, mean platelet volume and haematological parameters in patients with uncomplicated plasmodium falciparum and P. vivax malaria. F1000Res 2017; 6:865. [PMID: 28794861 PMCID: PMC5538039 DOI: 10.12688/f1000research.11767.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 01/22/2023] Open
Abstract
Background: The association between the haematological profile (including abnormal platelets) and malaria is not completely understood. There are few published data on haematological profiles of malaria patients in areas with unstable malaria transmission. The current study was conducted to investigate if the haematological parameters, including platelet indices, were reliable predictors for microscopically-diagnosed malaria infection. Methods: A case-control study with a total of 324 participants (162 in each arm) was conducted at the out-patient clinic of New Halfa hospital during the rainy and post rainy season (August 2014 through to January 2015). The cases were patients with uncomplicated
Plasmodium falciparum (107; 66.9%) and
P. vivax malaria (55, 34.0%) infections. The controls were aparasitemic individuals. The haematological parameters were investigated using an automated hemo-analyser. Results: There was no significant difference in the mean (±SD) age between the study groups; however, compared to the controls, patients with uncomplicated malaria had significantly lower haemoglobin, leucocyte and platelet counts, and significantly higher red cell distribution width (RDW), platelet distribution width (PDW) and mean platelet volume (MPV). Conclusions: The study revealed that among the haematological indices, PDW and MPV were the main predictors for uncomplicated
P. falciparum and P
. vivax malaria infection
. Abbreviations: OR: odds ratio.
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Affiliation(s)
- Elrazi A Ali
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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12
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Antwi-Baffour S, Adjei JK, Agyemang-Yeboah F, Annani-Akollor M, Kyeremeh R, Asare GA, Gyan B. Proteomic analysis of microparticles isolated from malaria positive blood samples. Proteome Sci 2017; 15:5. [PMID: 28352210 PMCID: PMC5366142 DOI: 10.1186/s12953-017-0113-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/17/2017] [Indexed: 01/06/2023] Open
Abstract
Background Malaria continues to be a great public health concern due to the significant mortality and morbidity associated with the disease especially in developing countries. Microparticles (MPs), also called plasma membrane derived extracellular vesicles (PMEVs) are subcellular structures that are generated when they bud off the plasma membrane. They can be found in healthy individuals but the numbers tend to increase in pathological conditions including malaria. Although, various studies have been carried out on the protein content of specific cellular derived MPs, there seems to be paucity of information on the protein content of circulating MPs in malaria and their association with the various signs and symptoms of the disease. The aim of this study was therefore to carry out proteomic analyses of MPs isolated from malaria positive samples and compare them with proteins of MPs from malaria parasite culture supernatant and healthy controls in order to ascertain the role of MPs in malaria infection. Methods Plasma samples were obtained from forty-three (43) malaria diagnosed patients (cases) and ten (10) healthy individuals (controls). Malaria parasite culture supernatant was obtained from our laboratory and MPs were isolated from them and confirmed using flow cytometry. 2D LC-MS was done to obtain their protein content. Resultant data were analyzed using SPSS Ver. 21.0 statistical software, Kruskal Wallis test and Spearman’s correlation coefficient r. Results In all, 1806 proteins were isolated from the samples. The MPs from malaria positive samples recorded 1729 proteins, those from culture supernatant were 333 while the control samples recorded 234 proteins. The mean number of proteins in MPs of malaria positive samples was significantly higher than that in the control samples. Significantly, higher quantities of haemoglobin subunits were seen in MPs from malaria samples and culture supernatant compared to control samples. Conclusion A great number of proteins were observed to be carried in the microparticles (MPs) from malaria samples and culture supernatant compared to controls. The greater loss of haemoglobin from erythrocytes via MPs from malaria patients could serve as the initiation and progression of anaemia in P.falciparum infection. Also while some proteins were upregulated in circulating MPs in malaria samples, others were down regulated.
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Affiliation(s)
- Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Jonathan Kofi Adjei
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana.,Department of Molecular Medicine, School of Medical Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Agyemang-Yeboah
- Department of Molecular Medicine, School of Medical Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Max Annani-Akollor
- Department of Molecular Medicine, School of Medical Sciences Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ransford Kyeremeh
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana
| | - George Awuku Asare
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Ben Gyan
- Noguchi Memorial Institute of Medical Research, University of Ghana, Legon, Ghana
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13
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Sánchez-Ovejero C, Benito-Lopez F, Díez P, Casulli A, Siles-Lucas M, Fuentes M, Manzano-Román R. Sensing parasites: Proteomic and advanced bio-detection alternatives. J Proteomics 2016; 136:145-56. [PMID: 26773860 DOI: 10.1016/j.jprot.2015.12.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/22/2015] [Accepted: 12/29/2015] [Indexed: 12/12/2022]
Abstract
Parasitic diseases have a great impact in human and animal health. The gold standard for the diagnosis of the majority of parasitic infections is still conventional microscopy, which presents important limitations in terms of sensitivity and specificity and commonly requires highly trained technicians. More accurate molecular-based diagnostic tools are needed for the implementation of early detection, effective treatments and massive screenings with high-throughput capacities. In this respect, sensitive and affordable devices could greatly impact on sustainable control programmes which exist against parasitic diseases, especially in low income settings. Proteomics and nanotechnology approaches are valuable tools for sensing pathogens and host alteration signatures within microfluidic detection platforms. These new devices might provide novel solutions to fight parasitic diseases. Newly described specific parasite derived products with immune-modulatory properties have been postulated as the best candidates for the early and accurate detection of parasitic infections as well as for the blockage of parasite development. This review provides the most recent methodological and technological advances with great potential for bio-sensing parasites in their hosts, showing the newest opportunities offered by modern "-omics" and platforms for parasite detection and control.
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Affiliation(s)
- Carlos Sánchez-Ovejero
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain
| | - Fernando Benito-Lopez
- Analytical Chemistry Department, Universidad del País Vasco UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Paula Díez
- Department of Medicine and General Cytometry Service-Nucleus, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Adriano Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, - 00161 Rome, Italy
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain
| | - Manuel Fuentes
- Department of Medicine and General Cytometry Service-Nucleus, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain.
| | - Raúl Manzano-Román
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain.
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14
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Philipose CS, Umashankar T. The role of haematological parameters in predicting malaria with special emphasis on neutrophil lymphocyte count ratio and monocyte lymphocyte ratio: A single Institutional experience. Trop Parasitol 2016; 6:147-150. [PMID: 27722104 PMCID: PMC5048702 DOI: 10.4103/2229-5070.190833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction: Malaria is a mosquito borne disease which is a major public health problem and a leading cause of morbidity and mortality worldwide. Various haematological parameters have been studied to help predict malaria, such as alteration in the leucocyte count, platelet counts and erythrocyte counts. The neutrophil lymphocyte count ratio (NLCR) was found to have a good predictive value in systemic inflammation, particularly in critical care setting. Aims and Objectives: The present study aims to study the various haematological parameters and acertain the predictive value of NLCR and MLR in the detection of malaria. Materials and Methods: A prospective cross sectional study was conducted at a tertiary care hospital between the period of August to December, 2014. A total of 200 smear positive malaria patients and a control group of 100 patients who were smear negative for malaria were included. Hemoglobin, Total leucocyte count, Differential leucocyte count, platelet counts and absolute counts were obtained. The NLCR and MLR were obtained from the above data. The data was analysed by statistical tools. Results: A total of 200 smear positive malaria cases were analysed of which, 180 cases were caused by the Plasmodium vivax parasite and 2 cases by Plasmodium Falciparum. Thrombocytopenia and leucopenia were found to have significant association with malaria. In the present study, the NLCR and MLR was not found to have significant association with malaria. Discussion: Although NLCR has been proven to be a useful marker for inflammation in many acute conditions5, it is albeit not of much significance in the prediction of malaria. Similarly we have found no significance of MLR in prediction of malaria.
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Affiliation(s)
| | - T Umashankar
- Department of Pathology, Father Muller Medical College, Mangalore, Karnataka, India
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15
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Anchang-Kimbi JK, Nkweti VN, Ntonifor HN, Apinjoh TO, Tata RB, Chi HF, Achidi EA. Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area. BMC Infect Dis 2015; 15:439. [PMID: 26494140 PMCID: PMC4619095 DOI: 10.1186/s12879-015-1211-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 10/13/2015] [Indexed: 11/15/2022] Open
Abstract
Background Pregnant women in malaria endemic areas are at high risk of P. falciparum infection and its complications. This study investigated the prevalence and risk factors for P. falciparum infection and malaria among pregnant women reporting for first antenatal care (ANC) clinic visit in the mount Cameroon area. Methods Venous blood samples from consented pregnant women were screened for malaria parasitaemia by light microscopy. Haemoglobin levels, white blood cell (WBC) counts, lymphocyte counts and percentage were determined using an automated haematology analyser. Socio-demographic/economic data, environmental factors and use of malaria control measures were documented. Univariate and multivariate statistical analyses were used. Results Sixty-eight (22.4 %; N = 303) of the women enrolled were positive for P. falciparum parasitaemia. Malaria parasitaemia was significantly (P < 0.001) associated with febrile illness. The overall prevalence of malaria and asymptomatic infection was 16.0 % (95 % CI = 11-20 %) and 10.5 % (95 % CI = 7.3-15 %) respectively. A greater proportion of the malaria cases (61 %) reported at the clinic during unscheduled days meanwhile women with asymptomatic parasitaemia mostly (92.8 %) seek for ANC during scheduled clinic days. Lower lymphocyte percentage was significantly associated with increase parasite density (r = − 0.34; P = 0.011) and febrile status (MU = 2.46; P = 0.014). While age and gravidity were significant factors associated with P. falciparum infection and/or malaria, the presence of bush and/or standing water around human residence was an independent risk factor of P. falciparum parasitaemia (OR = 3.3: 95 % CI = 1.6 – 7.0; P = 0.002) and malaria ( OR = 5.2: 95 % CI = 2.0 – 14; P = 0.001). Being unmarried was significantly associated with increase risk (OR = 2.6:95 % CI = 1.1 – 6.0; P = 0.032) of P. falciparum parasitaemia. Similarly, single women (938) had a significantly higher (t = 2.70; P = 0.009) geometric mean parasite density (GMPD) compared with married women (338). Conclusion Marital status and human residence in areas with bushes and/or standing water modify risk of P. falciparum infection and malaria. Education on early ANC attendance and environmental sanitation are important public health targets for malaria control in pregnancy in this setting.
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Affiliation(s)
| | - Vera Ngenwie Nkweti
- Department of Zoology and Animal Physiology, University of Buea, Buea, 63, Cameroon.
| | - Helen Ngum Ntonifor
- Department of Biological Sciences, University of Bamenda, Bamenda, Cameroon.
| | - Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon.
| | - Rolland Bantar Tata
- Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon.
| | - Hanesh Fru Chi
- Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon.
| | - Eric Akum Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon.
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Madukaku CU, Chimezie OM, Chima NG, Hope O, Simplicius DIN. Assessment of the haematological profile of children with malaria parasitaemia treated with three different artemisinin-based combination therapies. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(15)60813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Ketema T, Yohannes M, Alemayehu E, Ambelu A. Effect of chronic khat (Catha edulis, Forsk) use on outcome of Plasmodium berghei ANKA infection in Swiss albino mice. BMC Infect Dis 2015; 15:170. [PMID: 25886020 PMCID: PMC4392739 DOI: 10.1186/s12879-015-0911-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/23/2015] [Indexed: 12/22/2022] Open
Abstract
Background The objective of this study was to explore effects of khat (Catha edulis) on outcome of rodent malaria infection and its anti-plasmodial activities on Plasmodium berghei ANKA (PbA). Methods Female Swiss albino mice were orally treated with crude khat (Catha edulis) extracts (100, 200 and 300 mg/kg) on a daily basis for 4 weeks prior to PbA infection. Physical, clinical, hematological, biochemical and histo-pathological features of the mice were assessed. In addition, in vivo anti-plasmodial activities of khat were evaluated. Results The finding of this study showed that khat use was strongly associated with increment of levels of liver and kidney biomarkers, leucopenia, severe anemia, rise in level of inflammation biomarkers: C-reactive protein (CRP), uric acid (UA), increased monocyte-lymphocyte count ratio (MLCR), manifestation of cerebral malaria symptoms such as ataxia, paralysis and deviation of the head but with no pulmonary edema. Significantly lower level of parasitemia (P < 0.05), rectal temperature, but, high level of hemoglobin were observed at the early stage of the PbA infection in khat treated mice than the control. With extension of the treatment period, however, drastic increments were observed in parasite load and rectal temperature although there was reduction in hemoglobin (Hb) level. Moreover, khat showed poor anti-plasmodial activity with <10% parasite suppression activity and lack protection against major malaria symptoms. The significant reduction (P < 0.01) of hematological parameters during PbA infection strengthen the notion that hematological parameters could be good predictors of severe malaria complications in human. Conclusions In mice model treated with khat prior to infection with the rodent malaria parasite, khat was found to worsen manifestation of most malaria complications. Furthermore, the same plant showed poor in vivo anti-plasmodial activity and protection against major malaria symptoms.
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Affiliation(s)
- Tsige Ketema
- Department of Environmental Health Sciences and Technology, College of Health Sciences, Jimma University, Jimma, Ethiopia. .,Department of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia.
| | - Moti Yohannes
- Department of Microbiology and Veterinary Public Health, College of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia.
| | - Esayas Alemayehu
- School of Civil and Environmental Engineering, Jimma University Institute of Technology, Jimma, Ethiopia.
| | - Argaw Ambelu
- Department of Environmental Health Sciences and Technology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
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