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Intraleucocytic malaria pigment and clinical severity of malaria in children

O K Amodu1, A A Adeyemo, P E Olumese

  • 1Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria. sysop@nga.healthnet.org

Transactions of the Royal Society of Tropical Medicine and Hygiene
|August 6, 1998
PubMed

Insights

The proportion of neutrophils containing malaria pigment increases with disease severity in children. This simple count can help assess the severity of childhood malaria.

Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Pediatrics

Background:

  • Intraleucocytic malaria pigment has been proposed as a potential indicator of malaria severity.
  • Childhood malaria remains a significant public health challenge, particularly in high-transmission areas of Africa.
  • Accurate and simple markers for assessing malaria severity are crucial for effective patient management.

Purpose of the Study:

  • To evaluate the hypothesis that intraleucocytic malaria pigment, specifically in neutrophils and monocytes, correlates with malaria disease severity in children.
  • To determine if the proportion of pigment-containing neutrophils and monocytes can serve as a simple marker for childhood malaria severity.

Main Methods:

  • A study was conducted on 146 children (6 months to 14 years) in Ibadan, Nigeria, categorized into cerebral malaria, mild malaria, asymptomatic malaria, and no malaria groups.
  • Blood samples were analyzed to determine the proportion of neutrophils and monocytes containing malaria pigment.
  • Statistical analysis was performed to compare pigment levels across the different disease severity groups.

Main Results:

  • A significant and clear increase in the proportion of pigment-containing neutrophils was observed across the spectrum from no malaria to cerebral malaria (median values: 2.0% to 27.0%, P < 0.0001).
  • While pigment-containing monocytes showed no significant difference between mild, asymptomatic, and no malaria groups, the cerebral malaria group had a higher median value.
  • The ratio of pigment-containing neutrophils to monocytes mirrored the trend observed with neutrophils alone, reinforcing the association with disease severity.

Conclusions:

  • The count of pigment-containing neutrophils is a simple and effective marker for assessing disease severity in childhood malaria.
  • This finding adds a valuable, easily measurable parameter to complement parasite counts in the clinical management of pediatric malaria.
  • The study supports the utility of intraleucocytic malaria pigment as a readily available indicator of malaria severity in endemic regions.

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