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Might procalcitonin help predict imported falciparum malaria in children?
Alexandra Tielli1, Rachidou Ouorou2, Lauren Pull1
1Service D'accueil des Urgences Pédiatriques, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris (AP-HP), 75019, Paris, France.
Insights
Procalcitonin (PCT) levels can help assess malaria severity in children. A low PCT level may help rule out malaria in travelers, while higher levels indicate severe disease.
Area of Science:
- Biochemistry
- Infectious Diseases
- Pediatrics
Background:
- Procalcitonin (PCT) is a potential biomarker for malaria severity in adults.
- Its utility in pediatric malaria cases remains under investigation.
- A threshold of 10 ng/ml has been suggested for severe falciparum malaria in adults.
Purpose of the Study:
- To evaluate the effectiveness of PCT as a marker for malaria severity in children.
- To compare PCT levels between children with uncomplicated malaria, severe malaria, and healthy controls.
- To establish a PCT threshold for differentiating malaria severity in pediatric patients.
Main Methods:
- Retrospective case-control study design.
- Comparison of initial PCT levels in children with uncomplicated malaria versus controls.
- Comparison of PCT levels between children with uncomplicated and severe malaria.
Main Results:
- Malaria cases exhibited significantly higher PCT levels than controls.
- Severe malaria cases showed significantly higher PCT levels than uncomplicated cases.
- A PCT threshold of 0.65 ng/ml demonstrated high negative predictive value (98.8%) for malaria.
- Pooled analysis suggested a 6.17 ng/ml threshold for distinguishing severe from uncomplicated malaria.
Conclusions:
- Procalcitonin may serve as a valuable tool in diagnosing malaria in children.
- PCT can aid in predicting disease severity, potentially guiding treatment decisions.
- It may assist in ruling out malaria and assessing severity in pediatric patients and travelers.
Background:
Procalcitonin (PCT) has been proposed as a marker for malaria severity in adults, with a threshold of 10 ng/ml for severe falciparum disease. Whether PCT is useful in children is debated.
Patients & Methods:
A retrospective case-control study was conducted to compare initial PCT levels in children with uncomplicated malaria and a control group, and between children with uncomplicated and severe malaria.
Results:
Results showed significantly higher PCT levels in malaria cases compared to the control group and in malaria severe cases compared to uncomplicated cases. A Receiving Operator Characteristic curve established a PCT threshold of 0.65 ng/ml with a negative predictive value of 98.8 % based on a prevalence of 10 %. Analyzing the pooled results of five studies suggested a threshold of 6.17 ng/ml for differentiating uncomplicated and severe malaria.
Conclusion:
PCT might be a useful tool to help rule out malaria and predict potential disease severity in returning travelers.
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