Oxidative Stress and Hemoglobin Level of Complicated and Uncomplicated Malaria Cases among Children: A Cross-Sectional Study in Kumasi Metropolis, Ghana.

Kwabena Nsiah,Bernard Bahaah,Bright Oppong Afranie,Emmanuel Akowuah,Simon Koffie,Sampson Donkor

doi:10.1155/2019/8479076

Kwabena Nsiah, Bernard Bahaah + Show 4 more

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https://doi.org/10.1155/2019/8479076

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Abstract

Introduction Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and hence oxidant stress. Therefore, this study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. Method Subjects were recruited from hospitals in the Kumasi Metropolis. This was a cross-sectional study, involving 17 complicated malaria subjects, 51 uncomplicated malaria subjects, and 15 nonparasitemic subjects. The rapid diagnostic test (RDT) was used to determine presence or absence of falciparum malaria among the study participants. Blood samples from subjects were used to determine hemoglobin, malondialdehyde (MDA), and vitamin C levels. Results Majority of the subjects (67.5%) were within the age of 0-5 years. The mean age (±SD) of uncomplicated malaria subjects was 4.32 (±2.81) years, while that of complicated malaria was 4.27 (±2.96). Mean levels of HB decreased significantly in the following order: control subjects > uncomplicated malaria subjects > complicated malaria subjects (p<0.0001). Mean levels of MDA were significantly lower in control subjects compared to complicated malaria subjects (4.62±1.85 versus 6.68±0.70, p=0.0008) and also lowered in uncomplicated malaria subjects compared to complicated malaria (4.50±1.58 versus 6.68±0.70, p<0.0001). There was a statistically significant reduced mean level of vitamin C (p=0.036) in the following order: control subjects > uncomplicated malaria > complicated malaria subjects. However, for the complicated malaria cases, there were significantly higher mean vitamin C levels in females than in males (p<0.001). Conclusion Malaria progression increases MDA levels and decreases the ascorbate (vitamin C) and hemoglobin levels. It is recommended that future studies should investigate changes in other antioxidant vitamins, like vitamins A and E.

Highlights

Malaria is a leading cause of mortality among children below 5 years in Ghana
There were 17 subjects with severe or complicated malaria, 15 control subjects, and 51 subjects with uncomplicated malaria recruited into the study
For the complicated malaria cases, there was significant difference as mean value of serum vitamin C levels was lower in males than in females (p

Summary

Introduction

Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and oxidant stress. This study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. The parasites that invade the red cells cause the breakdown of hemoglobin This results in the generation of large amounts of reactive oxygen species (ROS) and reactive nitrogen species (RNS), causing a disparity between the activity of antioxidants and formation of oxidizing species. This disparity triggers oxidative stress, which is an important mechanism of human hosts, in response to infections [5]. A study by Guha and colleagues (2006) suggested that the generation of reactive oxygen and nitrogen species plays a crucial role in the development of systemic complications caused by malaria [7]

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