Abstract
Changes of lipid parameter concentrations are observed in patients suffering from malaria. However, there are few data on their evolution during the course of the infection and their relationship with the infection parameters. The levels of triglycerides (TG) and total cholesterol (TC) were measured during and after uncomplicated Plasmodium falciparum malaria in 122 children. The relationship with the antimalarial drug treatment, the parasite density and haemoglobin levels was also assessed. Mean TG levels were high before the treatment (1.9 ± 1.2 mmol/L) and at day 3 post-treatment (2.3 ± 1.3 mmol/L), then subsequently decreased to reach normal level from day 7. A negative correlation was found between haemoglobin (Hb) levels and TG (rho = -0.47; p < 0.01); previous high parasitaemia at inclusion was associated with a subsequent increase of TG levels after treatment administration. The majority of patients with hypertriglyceridemia were anaemic at day 3 (n = 20/20) and at day 7 (n = 18/19). Only 5 (4.1%) patients had hypertriglyceridemia at day 28. A trend toward a negative correlation between TC levels and parasite density was observed (rho = -0.18; p = 0.05). Mean TC concentration was significantly lower at day 0 when all the patients were parasitaemic (3.0 ± 1.0 mmol/L) compared to day 3 (3.7 ± 1.2 mmol/L) (p = 0.01). Mean CT was low during the first week and at day 28, 71 (58.2%) children still had a subnormal CT levels. No relationship was found with the type of antimalarial drug. Transient hypertriglyceridemia and hypocholesterolemia are observed during the course of P. falciparum infection. High TG levels seem to be related to the malaria related haemolysis. Key words: Malaria, cholesterol, triglycerides, antimalarial, Gabon.  
Highlights
Lipid parameter changes have been reported during the course of malaria infection
Anaemia was defined as an Hb concentration below 11 g/dl, hypocholesterolemia or low total cholesterol when serum cholesterol level was below 4.0 mmol/L and hypertriglyceridemia when serum triglyceride level was higher than 1.88 mmol/L
The present study confirmed that P. falciparum infection is characterized by hypertriglyceridemia and hypocholesterolemia
Summary
Lipid parameter changes have been reported during the course of malaria infection. the mechanisms involved are not fully understood, some hypotheses have been raised from in vivo and in vitro studies (Cuisinier et al, 1990; Visser et al, 2013). Cholesterol and triglycerides are the most common studied lipid parameters during malaria infection. Liver function disorders and anaemia caused by red blood cell destruction are the main markers of uncomplicated malaria beside fever They are characterized by a decrease in hemoglobin levels and an increase in liver enzymes. Antimalarial treatment has been shown to be responsible for changes in triglycerides and cholesterol levels in patients with malaria (Davis et al, 1995; Bouyou-Akotet et al, 2010). Suffering from uncomplicated malaria who took part in two clinical trials performed between 2005 and 2006 as described elsewhere (Bouyou-Akotet et al, 2010; Nsimba et al, 2008) These patients were treated either with amodiaquine (AQ), sulfadoxinepyrimethamine (SP) or artesunate-mefloquine (AM) according to their age and/or weight following World Health Organization (WHO). They were included with the following criteria: presence of P. falciparum mono-infection, fever or history of fever during the last 24 h, absence of signs of severe malaria, malnutrition or other severe underlying infectious or chronic disease
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