Abstract
BackgroundCardiovascular parameters can be impaired by repeated infections with P. falciparum. This study aimed at investigating the influence of gametocyte carriage on; the prevalence of fever and splenomegaly, blood pressure, heart rate and haematological indices in children <15 years, in the Mount Cameroon area.MethodsA cross-sectional study was carried out, from February to July 2013. A child with axillary body temperature ≥37.5 °C was considered febrile and splenomegaly was investigated by palpation. Systolic and diastolic blood pressures as well as heart rate were assessed by non-invasive methods. Malaria parasites were detected and density assessed from Giemsa-stained thin and thick blood films. An auto haematology analyser was used to obtain complete blood count values such as haemoglobin (Hb), haematocrit (Hct), red blood cell (RBC) and white blood cell (WBC) counts, mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC), and mean corpuscular haemoglobin (MCH). Univariate analyses were used to examine influence of gametocyte carriage on fever and splenomegaly while, multiple linear regression models were used to evaluate influence of independent variables on the dependent variables.ResultsOf a total of 454 children examined, malaria parasitaemia, fever, splenomegaly and gametocyte carriage were detected in 36.6, 21.6, 14.3 and 7.3 % of them respectively. Children who were asexual parasite and gametocyte positive (ASP + Gam Pos) had significantly highest (P = 0.03, P = 0.002) prevalence of fever and splenomegaly (39.4 %, 33.3 %) respectively than their aparasitaemic (AP) and asexual parasite positive (ASP Pos) equivalents (19.0 %, 10.9 % and 22.8 %, 16.9 % respectively). The presence of asexual malaria parasitaemia significantly influenced the MCV (P = 0.03), MCH (P = 0.03) and heart beats /min (0.03) while gametocytaemia significantly influenced the Hb (P < 0.001), Hct (P < 0.001), RBC (P < 0.001) and systolic blood pressure (P < 0.05).ConclusionGametocyte carriage significantly influenced the prevalence of fever, splenomegaly and some cardiovascular indices. In effect, children concurrently having asexual parasitaemia and gametocytes had significantly lower, Hct, Hb levels, RBC and platelet counts and systolic blood pressure.
Highlights
Cardiovascular parameters can be impaired by repeated infections with P. falciparum
The aim of this study was to investigate the additive effect of gametocyte carriage in children with malaria parasitaemia on the prevalence of fever and splenomegaly, on blood pressure, heart rate and haematological indices in children living in the Mount Cameroon area
Baseline characteristics of the study population A total of 454 children with a mean age of 6.7 ± 3.4 years of both sexes residing in Muea in the Mount Cameroon area were evaluated for the influence of gametocyte carriage on splenic status and cardiovascular indices
Summary
Cardiovascular parameters can be impaired by repeated infections with P. falciparum. An estimated 3.3 billion people in 97 countries and territories are at risk of being infected with malaria parasite and developing disease [1]. Majority of patients present with fever, but fever alone remains a poor discriminator of malaria infection the need to confirm or refute the role of malaria in febrile presentation [2]. Malaria transmission from an infected human host to a female anopheline mosquito is mediated through highly specialized sexual-stage parasites, i.e., gametocytes. Host immune response (including co-infection with other pathogens), host anaemia, insecticide spraying, and mass drug administration are likely to influence the appearance of gametocytes at presentation [3]. Clinically immune infections often have lower gametocytemia as a result of having anti-parasite immunity, conferring protection against high-density parasitaemia [4]
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