Udoh BE, Iwalokun BA, Etukumana E, Amoo J. Asymptomatic
falciparum Malaria and its Effects on Type 2 Diabetes Mellitus Patients in Lagos, Nigeria.
SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2019;
8:32-40. [PMID:
31929776 PMCID:
PMC6945314 DOI:
10.4103/sjmms.sjmms_178_18]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/25/2018] [Accepted: 05/16/2019] [Indexed: 11/04/2022]
Abstract
Background
Asymptomatic malaria (ASM) constitutes a reservoir of malaria parasites that sustain transmission and threaten elimination efforts. Studies have also shown a significant relation between insulin resistance and malaria infection. However, data on the clinical effects of ASM and its patterns of carriage among adult malaria patients is limited.
Objectives
To determine the prevalence of ASM due to Plasmodium falciparum among adult type 2 diabetes (T2DM) patients in Lagos, Nigeria; to assess the diagnostic performance of light microscopy and histidine-rich protein 2 rapid diagnostic test (HRP-2 RDT); and to determine the effects of ASM on glycemic control and anemia.
Materials and Methods
This cross-sectional study enrolled 208 afebrile, nonobese, nonhypertensive T2DM patients, aged 40-70 years, undergoing treatment (adherence, ≥95%) at six private health facilities in Lagos, Nigeria, between March and August 2015. Sociodemographic data were obtained using a semi-structured questionnaire and clinical case files. Venous blood samples were collected and processed for fasting blood sugar estimation, packed cell volume determination and malaria parasite detection by HRP2-RDT, light microscopy and polymerase chain reaction (PCR).
Results
The mean age of the patients was 54.5 years. ASM was diagnosed in 16.8%, 7.2% and 4.3% of the patients by PCR, light microscopy and HRP2-RDT, respectively. ASM was significantly (P < 0.05) associated with poor glycemic control, anemia and insulin resistance. The overall parasitemia ranged from 85 to 3789 parasites/μL (median, 1580 parasites/μL). Benchmarking against the PCR results, light microscopy and rapid diagnostic tests were found to have a sensitivity (95% confidence interval) of 42.9% (26.5-59.3) and 22.9% (12.1-39), respectively, in diagnosing ASM.
Conclusion
This study revealed that T2DM patients in Lagos, Nigeria, are potential reservoirs of asymptomatic Plasmodium falciparum, which has a significantly negative effect on glycemic control and anemia. The study also found PCR to be the most effective diagnostic method.
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