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Published on: January 2, 2013
A community study of T lymphocyte subsets and malaria parasitaemia
1Department of Pathology, Hvidovre University Hospital, Copenhagen, Denmark.
Insights
Acute malaria in children significantly lowers total CD4 and CD8 T cell counts. Asymptomatic Plasmodium falciparum infections may also impact T cell subsets, acting as a confounder in tropical studies.
Area of Science:
- Immunology
- Infectious Diseases
- Tropical Medicine
Background:
- Plasmodium falciparum malaria is a major public health concern in tropical regions.
- T cell subsets play a critical role in immune response and are affected by various infections.
- Understanding the impact of malaria on T cell subsets is crucial for immune modulation strategies.
Purpose of the Study:
- To investigate the relationship between Plasmodium falciparum parasitaemia and T cell subsets in children.
- To determine if acute malaria or asymptomatic parasitaemia affects T cell counts and percentages.
- To identify potential confounders in community-based immunological studies in malaria-endemic areas.
Main Methods:
- Community-based survey of 312 children aged 3-6 years in urban Guinea-Bissau.
- Assessment of Plasmodium falciparum parasitaemia and clinical malaria (fever and parasite density).
- Analysis of T cell subsets (CD4, CD8) including total counts and percentages via flow cytometry.
Main Results:
- Children with acute malaria exhibited lymphopenia with significantly lower total CD4 and CD8 T cell counts.
- Asymptomatic parasitaemia was associated with a significantly lower percentage of CD4 cells compared to uninfected children.
- CD4 cell percentage showed an inverse correlation with malaria parasite density, independent of other factors.
Conclusions:
- Acute Plasmodium falciparum malaria significantly depresses total CD4 and CD8 T cell counts.
- Asymptomatic parasitaemia can alter T cell subset percentages, potentially confounding immunological research.
- Careful consideration of parasitaemia status is essential for accurate interpretation of T cell subset data in tropical settings.
Abstract:
In a community survey of 312 children aged 3-6 years in urban Guinea-Bissau, we examined Plasmodium falciparum parasitaemia and T cell subsets. 183 children (59%) had parasites in their blood, 13 had fever > or = 37.5 degrees C, and 9 (3%) had fever and a parasite density > 5000/microL (clinical malaria). Compared with children with no parasitaemia or asymptomatic parasitaemia, children with acute malaria had lymphopenia and significantly lower total CD4 and CD8 cell counts, but there was no significant difference in white blood cell count percentages of CD4 and CD8 cells, or the CD4/CD8 ratio. Children with parasitaemia but without fever had a significantly lower percentage of CD4 cells than children without parasites (P = 0.031), but did not differ in any other haematological index. Controlling for other factors, the CD4 cell percentage was inversely correlated with the density of malaria parasites (P = 0.024), whereas there was no association with CD8 cell percentage or the CD4/CD8 ratio. Asymptomatic parasitaemia may be an important confounder in general community studies of T cell subsets in the tropics.
