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Published on: May 16, 2013
Haematological parameters, haemozoin-containing leukocytes in Sudanese children with severe Plasmodium falciparum
Magdi M Salih1, Hatim G Eltahir2, Tajeldin M Abdallah3
1University of Khartoum, Khartoum, Sudan. magdi-206@hotmail.com.
Insights
Haemozoin-containing leucocytes (HCL) and specific blood parameters like RDW and PDW can help predict severe malaria in children. This finding aids in early diagnosis and management of severe Plasmodium falciparum malaria.
Area of Science:
- Malariology
- Hematology
- Parasitology
Background:
- Haemozoin-containing leucocytes (HCL) are potential biomarkers for predicting severe malaria.
- Early identification of severe malaria cases is crucial for timely intervention.
Purpose of the Study:
- To investigate haematological values and HCL in children with severe Plasmodium falciparum malaria.
- To assess the predictive value of HCL and blood parameters for severe malaria.
Main Methods:
- A case-control study was conducted in Sudan involving children with severe malaria, uncomplicated malaria, and healthy controls.
- Haematological parameters including haemoglobin, platelet counts, lymphocyte counts, red cell distribution width (RDW), and platelet distribution width (PDW) were analyzed.
- The presence of haemozoin in monocytes (HCL) was quantified, and Receiver Operating Characteristic (ROC) curves were used to evaluate predictive values.
Main Results:
- Children with severe malaria exhibited significantly lower haemoglobin and platelet counts, and higher lymphocyte counts, RDW, and PDW compared to those with uncomplicated malaria.
- A high percentage of children with severe malaria (91.0%) and uncomplicated malaria (84.6%) tested positive for HCL.
- ROC curve analysis indicated fair predictability for severe malaria using haemoglobin, lymphocytes, PDW, and HCL.
Conclusions:
- Red cell distribution width (RDW), platelet distribution width (PDW), and haemozoin-containing leucocytes (HCL) show potential as predictors of severe malaria.
- These parameters can aid in the clinical assessment and prediction of severe malaria in endemic settings.
Introduction:
Haemozoin -containing leucocytes (HCL) can be used to predict severe malaria.
Methodology:
A case -control study was conducted in Singa, Sudan, to investigate the haematological values and HCL in children with severe Plasmodium falciparum malaria. The cases were children with severe P. falciparum malaria (67). The two groups of controls were patients with uncomplicated P. falciparum malaria (63) and healthy children (50).
Results:
The mean (±SD) age was 5.5 (±3.8) years. In comparison with children with uncomplicated P. falciparum malaria, children with severe P. falciparum malaria had significantly lower haemoglobin and platelet counts, and significantly higher lymphocyte counts, red cell distribution width (RDW), and platelet distribution width (PDW). The rate of haemozoin -containing monocytes (percentage of children positive for this parameter in each group) was 91.0%, 84.6% and 50.0%, P<0.001 in children with severe P. falciparum, uncomplicated P. falciparum malaria and negative controls, respectively. Receiver Operating Characteristic (ROC) curves for blood parameters and HCL were plotted and the areas under the curve (AUC) were calculated for the prediction of severe P. falciparum malaria infection. The ROC curve analysis, showed a fair predictability of malaria for haemoglobin (AUC = 0.74, sensitivity = 76.0% and specificity = 60.3%, cut-off = 9.7g/dl), lymphocytes (AUC = 0.71, sensitivity = 71.3% and specificity = 62.2%, cut-off = 1.95×103/mm3), PDW (AUC = 0.69, sensitivity = 80.1% and specificity = 66.3%, cut-off = 15.34 %) and haemozoin in the monocytes (AUC = 0.68, sensitivity = 68.2% and specificity = 65.2%, cut-off =5.5 %).
Conclusion:
RDW, PDW and HCL could be used to predict severe malaria in this setting.
