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Methaemoglobin and COHb in patients with malaria
Thomas Hänscheid, Tom Gresnigt, Sascha Löhr
1Centre de Recherches Médicales en Lambaréné (CERMEL), Hôpital Albert Schweitzer, Lambaréné, Gabon. M.P.Grobusch@amc.uva.nl.
Malaria Journal
|July 25, 2014
Summary
Haemolytic conditions and malaria may alter methaemoglobin (MetHb) levels. While MetHb differences were small in malaria patients, non-invasive MetHb testing could aid prognosis in resource-poor settings.
Area of Science:
- Hematology
- Infectious Diseases
- Clinical Chemistry
Background:
- Haemolytic conditions release free haemoglobin and toxic haem, potentially altering MetHb and COHb levels.
- This hypothesis suggests a link between free haem, MetHb, and COHb in conditions like malaria and sepsis.
Purpose of the Study:
- To investigate the association between haemolysis markers (MetHb, COHb) and malaria.
- To evaluate the potential of non-invasive MetHb testing for malaria prognosis.
Main Methods:
- Retrospective analysis of arterial blood gas results from Lisbon and Berlin (severe malaria patients).
- Prospective study of non-invasive MetHb measurements in children with and without malaria in Gabon.
Main Results:
- In Lisbon, mean MetHb was 1.4%; few infections showed MetHb >3.0%. COHb showed no clear clinical association.
- In Berlin, severe malaria patients had a mean MetHb of 1.29%, with no significant difference between cerebral and non-cerebral malaria.
- In Gabon, children with malaria (mean MetHb 1.77%-2.05%) had slightly higher MetHb than healthy children (mean 1.57%), with significant differences in complicated cases.
Conclusions:
- Findings support the methaemoglobin/haem hypothesis in malaria and sepsis.
- Observed MetHb differences in African children with malaria were small but significant.
- Non-invasive MetHb testing warrants further evaluation as a simple prognostic tool for resource-limited settings.
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