[Prognostic value of lactate determination in cerebral malaria in the Cameroonian child]
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G Lando1, R Djiogue, S Djoumessi
1Service de Biochimie, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé, Cameroun.
Insights
Cerebral malaria in Cameroonian children disrupts glucose metabolism, often leading to hyperglycemia and elevated lactate levels. This study highlights a correlation between parasite levels and lactate, crucial for understanding malaria
Area of Science:
- Pediatrics
- Infectious Diseases
- Metabolic Disorders
Context:
- Malaria remains a significant health challenge in sub-Saharan Africa, particularly affecting children.
- Cerebral malaria and severe malaria cases present complex clinical pictures with potential metabolic disturbances.
- Understanding glucose metabolism alterations is vital for managing severe pediatric malaria.
Purpose:
- To investigate glucose metabolism disturbances in Cameroonian children with cerebral malaria and severe malaria.
- To analyze the relationship between parasitemia, blood glucose levels, insulin, and lactate.
- To identify specific metabolic profiles associated with different malaria severities in pediatric patients.
Summary:
- This study examined 61 Cameroonian children (1-15 years) with cerebral or severe malaria.
- Hyperglycemia was observed in 15 patients, and hypoglycemia in 4 (all cerebral malaria).
- Elevated lactate levels were more frequent in cerebral malaria (74%) versus severe malaria (37%), correlating positively with parasitemia.
Impact:
- Findings underscore the metabolic impact of malaria, particularly cerebral malaria, on pediatric patients.
- Highlights the potential role of lactate as a biomarker in severe malaria.
- Informs clinical management strategies by identifying key metabolic derangements in pediatric malaria.
Abstract:
In this study, we investigated the disturbances of glucose metabolism in 61 Cameroonian children aged 1 to 15 years old, infected with cerebral malaria and severe malaria cases admitted in hospitals in Yaoundé. Parasitaemia in the two groups was respectively 8.10 +/- 0.35% in cerebral malaria group and 4.47 +/- 0.84% in those admitted for severe malaria. The majority of our patients (n = 42) had normal glycaemia, while 15 cases were hyperglycemic and only 4 subjects all belonging to the cerebral malaria group were hypoglycemic. No case of hyperinsulinaemia was recorded. The level of lactate was higher in 74% of patients (19 over 26) admitted for cerebral malaria virsus 37% patients (13 over 35) admitted for severe cases. We found a positive correlation between the level of parasite and that of lactate (P < 0.01 r = 0.47). Whereas no positive correlation was found in one hand between the level of parasite and glycaemia, the level of parasites and insulin, and in the other hand between glycaemia and the level of lactate, glycaemia and insulin.