Abstract
BackgroundEven though malaria is generally on the decline due extensive control and elimination efforts, it still remains a public health problem for over 40% of the world’s population. During the course of malaria infection, parasites and red blood cells come under oxidative stress and there is host immune response in an attempt to protect the red blood cells. The frequency of monocytes and lymphocytes in peripheral blood might, therefore, be expected to reflect the state of an individual’s immune response to the infection. Circulating monocytes and lymphocytes could therefore serve as an index in relation to malaria parasitaemia. The purpose of this study was to determine whether the relative count of monocytes to lymphocytes in peripheral blood (M:L ratio) can predict parasitaemia and, therefore, the severity of malaria infection.MethodsTwo millilitre of venous blood sample were taken from participants by venisection into anticoagulant tubes. Thick and thin blood films were made and stained with Giemsa and examined for malaria parasites. Whole blood specimen were analysed for full blood count using ABX Pentra 60 C+ automated haematological analyzer. Data was entered into Microsoft Word and analysed using Statistical Package for Social Sciences (SPSS, Version 20.0) and Graphpad prism. Spearman’s correlation was used to determine correlation between occurrences of clinical malaria and the monocytes and lymphocytes ratio. Statistical significance was taken as p ≤ 0.05 with 95% confidence interval.ResultsThe study comprised of 1629 (m = 896; f = 733) children up to 5 years presenting with clinical malaria as cases and 445 (m = 257; f = 188) apparently healthy children as controls. The results indicated that there was a significant positive correlation between the monocytes to lymphocytes ratio and the presence of parasites (p = 0.04) and the level of parasitaemia within the age group of 0–3 years (p = 0.02) and 4–5 years (p = 0.03).ConclusionsThe monocyte to lymphocyte ratio obtained correlated positively with the presence of malaria as well as the level of parasitaemia. The outcome of this work implies that monocyte to lymphocyte ratio can be used to predict the level of parasitaemia and together with other factors, the development of severe malaria.
Highlights
Even though malaria is generally on the decline due extensive control and elimination efforts, it still remains a public health problem for over 40% of the world’s population
During the course of malaria infection, parasites and red blood cells come under oxidative stress and there is host immune response in terms of changes in monocyte and lymphocyte population in attempt to protect the red blood cells
Setting of the study The study was conducted across Ghana in three regional hospitals namely: the Korle-bu Teaching Hospital for the southern sector, the Sunyani Regional Hospital for the middle sector and the Wa Regional Hospital to cover the northern sector of the country
Summary
Even though malaria is generally on the decline due extensive control and elimination efforts, it still remains a public health problem for over 40% of the world’s population. Four Plasmodium species have been known to cause malaria infection in humans namely; Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. P. falciparum is the most common in sub-Saharan Africa and responsible for the majority of severe malaria and malaria deaths globally. Severe malaria is defined as acute malaria with signs of organ dysfunction and/or high level of parasitaemia [6]. It is defined by the demonstration of asexual forms of the malaria parasites in the blood in a patient with a potentially fatal manifestation or complication of malaria in whom other diagnoses have been excluded [7, 8]. P. vivax and P. ovale have an added dormant liver stage in their life cycle, which can be reactivated in the absence of a mosquito bite, leading to clinical symptoms [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
