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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.
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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