Malaria Infection In Children Research Articles

The role of immune-inflammatory markers in children with complicated and uncomplicated malaria in Enugu, Nigeria

BackgroundThere is currently insufficient data regarding immune parameters and relationship with severity of malaria infection in Enugu, Nigeria where the economic and social costs of the disease and its management are extremely high. This study was conducted to determine the relationship between malaria severity and some immune-inflammatory markers among malaria-infected children in Enugu, Nigeria.MethodsThe study adopted a case control design. Eligible children were categorized into three groups — complicated, uncomplicated and healthy children. Pro-inflammatory cytokines –interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α); and anti-inflammatory cytokine — interleukin-10 (IL-10) were assayed using enzyme-linked immunosorbent assay (ELISA) technique, while immune cell ratios — neutrophil lymphocyte ratio (NLR) and monocyte lymphocyte ratio (MLR) were calculated from full blood count results.ResultsThe overall mean age of the participants was 7.3 ± 3.4 (range: 6 months − 12 years) and the male-female ratio was 1:1. There was no significant difference between the ages of the three groups (P = 0.44). The Mean levels of IFN-γ, TNF-α, and NLR were higher in complicated than uncomplicated malaria (266.9 ± 66.3pg/ml vs. 62.5 ± 6.4pg/ml, p < 0.001; 140.3 ± 30.0pg/ml vs. 42.0 ± 9.0pg/ml, p < 0.001; and 32.9 ± 16.2pg/ml vs. 17.8 ± 6.0pg/ml, p < 0.001, respectively); and higher in uncomplicated malaria than healthy children (62.5 ± 6.4pg/ml vs. 40.6 ± 9.1pg/ml, p < 0.001; 42.0 ± 9.0pg/ml vs. 105.7 ± 32.1, p < 0.001; 17.8 ± 6.0pg/ml vs. 18.7 ± 6.2pg/ml, p < 0.001, respectively). On the other hand, the mean level of IL-10 is higher in uncomplicated than complicated malaria (105.73 ± 32.06pg/ml vs. 40.60 ± 9.11pg/ml, p < 0.001). There was a positive correlation between NLR and IFN-γ (r = 0.815; p = 0.003), as well as NLR and TNF-α (r = 0.745; p = 0.002).ConclusionComplicated malaria is associated with higher levels of pro-inflammatory cytokines while uncomplicated malaria is associated with higher levels of anti-inflammatory cytokines. NLR correlates positively with pro-inflammatory cytokines, and could be useful in evaluation for the severity of malaria infection.

PREVALENCE OF MALARIA, THE EFFECT OF PARASITAEMIA ON BLOOD PARAMETERS AND IRON LEVEL OF INFECTED CHILDREN UNDER FIVE YEARS OF AGE IN ITU, SOUTH-SOUTH, NIGERIA

Malaria is a devastating public health concern in Itu with varied haematological and biochemical implications. This study seeks to crystalize the prevalence of malaria, the effect of parasitaemia on some haematological parameters, and serum iron level of infected children under 5 in Itu Local Government Area, Nigeria. The study adopted a cross-sectional study involving 430 children. Blood samples were obtained from consented caregivers. Malaria prevalence and parasitaemia level were diagnosed microscopically. Haematology auto-analyzer was used to determine haematological parameters. Malaria prevalence of 41.08% was recorded in the study. The highest prevalence (42.86%) was reported among the female subjects. The difference in the infection rate between males and females was statistically significant (p&lt;0.05). The infected children tended to have significantly lower mean haemoglobin, packed cell volume, red blood cell level, lymphocyte, monocytes, and eosinophil count, (p &lt; 0.005) and a higher mean neutrophil, as well as white blood cell count (p &lt; 0.05) compared to the non-infected subjects respectively. A weak correlation between the level of parasitaemia and Hb (r= 0.108), PCV(r=0.247), RBC (r= o.074), and a weak negative with WBC (r = -0.063) was also reported. The study also recorded a higher mean serum ferritin level (648 ng/ml) compared to non-infected, lower mean serum transferrin (6.41 ng/ml) compared to normal, and mean serum iron (54.40 ng/ml) was higher than normal. It is essential to pay keen attention to the evaluation of haematological and biochemical parameters in the management of malaria infection in children living in malaria-endemic areas.

Host-parasite interaction in severe and uncomplicated malaria infection in ghanaian children.

During malarial infection, both parasites and host red blood cells (RBCs) come under severe oxidative stress due to the production of free radicals. The host system responds in protecting the RBCs against the oxidative damage caused by these free radicals by producing antioxidants. In this study, we investigated the antioxidant enzyme; superoxide dismutase (SOD) activity and cytokine interactions with parasitaemia in Ghanaian children with severe and uncomplicated malaria. One hundred and fifty participants aged 0-12 years were administered with structured questionnaires. Active case finding approach was used in participating hospitals to identify and interview cases before treatment was applied. Blood samples were taken from each participant and used to quantify malaria parasitaemia, measure haematological parameters and SOD activity. Cytokine levels were measured by commercial ELISA kits. DNA comet assay was used to evaluate the extent of parasite DNA damage due to oxidative stress. Seventy - Nine (79) and Twenty- Six (26) participants who were positive with malaria parasites were categorized as severe (56.75 × 103 ± 57.69 parasites/µl) and uncomplicated malaria (5.87 × 103 ± 2.87 parasites/µl) respectively, showing significant difference in parasitaemia (p < 0.0001). Significant negative correlation was found between parasitaemia and SOD activity levels among severe malaria study participants (p = 0.0428). Difference in cytokine levels (IL-10) amongst the control, uncomplicated and severe malaria groups was significant (p < 0.0001). The IFN-γ/IL-10 /TNF-α/IL-10 ratio differed significantly between the malaria infected and non- malaria infected study participants. DNA comet assay revealed damage to Plasmodium parasite DNA. Critical roles played by SOD activity and cytokines as anti-parasitic defense during P. falciparum malaria infection in children were established.

Association between malaria parasite density and hematological profile in malaria infected children at a Nigerian Private hospital.

The correct association between Plasmodium falciparum parasite density and the cellular constituents of blood is not known in entirety in Nigerian children. Thus, we decided to study the association between cellular blood constituents and malaria parasite density in malaria infected children attending a Nigerian hospital. A study of all children diagnosed with malaria fever at the Pediatric out-patient clinic, Cedar Crest Hospital, Abuja, Nigeria, was conducted. Packed cell volume, white blood cells with differentials and platelet counts and malaria parasite densities obtained from blood samples were studied. Malaria parasite densities more than 2 pluses were classified as significant parasitemia and 1 plus as non-significant. Information obtained was recorded and analysed with SPSS 22 software. A total 143 children (74 boys and 69 girls) diagnosed with malaria of ages between 5 months to 17 years (mean 5.24 ±4.60) were studied. The majority of 141 (98.6%) had non-significant P. falciparum parasitemia, while 2 (2.4%) had significant parasitemia. Of the 143 children with malaria, 116 (81.1%) had a normal leucocyte count. All children with significant parasitemia had a normal leucocyte count. Of the 143 children, 11 (7.7%) had anemia and 10 (7.0%) thrombocytopenia. Anemia, monocytosis and thrombocytopenia were significantly associated with significant malaria parasitemia (p<0.05). Mean platelet counts was significantly less amongst those with significant parasitemia (p<0.01). All patients with significant malaria parasitemia had normal leucocyte count. Significant malaria parasitemia is significantly associated with anemia, thrombocytopenia and monocytosis. Blood film appearances showing these changes are suggestive of significant malaria parasitemia.

Paediatric Malaria: Associated Symptoms and Risk Factors among Children in Isheri, Alimosho Local Government Area, Lagos State, Nigeria

Malaria is a significant health issue, especially in tropical and subtropical regions. Children are particularly vulnerable to malaria due to their underdeveloped immune systems. Although many countries have implemented interventions to control and eliminate malaria, the disease remains a major public health challenge in endemic areas. This study is a cross-sectional survey conducted to determine the prevalence of paediatric malaria and identify associated risk factors in children under 5 years old at the Isheri Primary Health Centre in the Alimosho Local Government Area of Lagos State. The survey was carried out from June to September 2023. Blood samples were collected from 219 children, 44.7% male and 55.3% female. Parasitological analysis was conducted according to WHO standards, and data on associated risk factors and malaria prevention practices were collected through a pretested structured questionnaire. Statistical analyses such as T-test and One-way ANOVA were employed, with significance set at p&gt;0.05. The findings revealed an overall prevalence of paediatric malaria in the study location at 49.3% (n=108), with P. falciparum being the main parasite. Males had a 55.1% malaria infection rate, while females had a rate of 40.5%. All malaria-infected children tested positive for the asexual malaria parasite, with parasite density ranging from 2087 to 328000μL-1 and a mean value of 47267 — 80 (95% CI 35244-59292). Children &lt; 5years of age (55324 μL-1, 95% CI 29378-81271) had slightly higher asexual parasite density than those &gt; 5 years (44045μL-1, 95% CI 30440-576550). Haematological analysis showed that the infected children had a significantly higher count of neutrophils than the uninfected (p = 0.002). Furthermore, children who did not report experiencing fever and chills had a significantly higher parasite density than those who did (p&lt;0.05). The use of insecticide-treated bed nets (ITN) also had an impact, with children under 5 years of age not using ITNs having a higher parasite density (65390 μL-1, 95% CI 18219-112562) than those who did. The study also assessed environmental risk factors and found that stagnant water and poultry farms did not significantly impact the prevalence of paediatric malaria. The study concluded that improved access to malaria interventions is essential to interrupt transmission, particularly in the at-risk groups, to achieve the United Nations Sustainable Development Goals agenda for health.

Higher platelet counts and platelet factors are associated with a reduction in Plasmodium falciparum parasite density in young Malian children

ObjectivesThe association between thrombocytopenia and parasite density or disease severity is described in numerous studies. In recent years, several studies described the protective role of platelets in directly killing Plasmodium parasites, mediated by platelet factor 4 (PF4) binding to Duffy antigen. This study aimed to evaluate the protective role of platelets in young children who are Duffy antigen-negative, such as those in sub-Saharan Africa. MethodsA zero-inflated negative binomial model was used to relate platelet count and parasite density data collected in a longitudinal birth cohort. Platelet factors were measured by enzyme-linked immunosorbent assay in samples collected from malaria-infected children who participated in a cross-sectional study. ResultsWe described that an increase of 10,000 platelets/μl was associated with a 2.76% reduction in parasite count. Increasing levels of PF4 and CXCL7 levels were also significantly associated with a reduction in parasite count. ConclusionsPlatelets play a protective role in reducing parasite burden in Duffy-negative children, possibly mediated through activation of the innate immune system.

High genetic and haplotype diversity in vaccine candidate Pfceltos but not Pfrh5 among malaria-infected children in Ibadan, Nigeria

Malaria remains a global public health challenge. The disease has a great impact in sub-Saharan Africa among children under five years of age and pregnant women. Malaria control programs targeting the parasite and mosquitoes vectors with combinational therapy and insecticide-treated bednets are becoming obsolete due to the phenomenon of resistance, which is a challenge for reducing morbidity and mortality. Malaria vaccines would be effective alternative to the problem of parasite and insecticide resistance, but focal reports of polymorphisms in malaria candidate antigens have made it difficult to design an effective malaria vaccine. Therefore, studies geared towards elucidating the polymorphic pattern and how genes targeted for vaccine design evolve are imperative. We have carried out molecular and genetic analysis of two genes encoding vaccine candidates—the Plasmodium falciparum cell traversal ookinetes and sporozoites (Pfceltos) and P. falciparum reticulocyte binding protein 5 (Pfrh5) in parasite isolates from malaria-infected children in Ibadan, Nigeria to evaluate their genetic diversity, relatedness and pattern of molecular evolution. Pfceltos and Pfrh5 genes were amplified from P. falciparum positive samples. Amplified fragments were purified and sequenced using the chain termination method. Post-sequence edit of fragments and application of various population genetic analyses was done. We observed a higher number of segregating sites and haplotypes in the Pfceltos than in Pfrh5 gene, the former also presenting higher haplotype (0.942) and nucleotide diversity (θ = 0.01219 and π = 0.01148). In contrast, a lower haplotype (0.426) and nucleotide diversity (θ = 0.00125; π = 0.00095) was observed in the Pfrh5 gene. Neutrality tests do not show deviation from neutral expectations for Pfceltos, with the circulation of multiple low frequency haplotypes (Tajima’s D = −0.21637; Fu and Li’s D = −0.08164; Fu and Li’s F = −0.14051). Strong linkage disequilibrium was observed between variable sites, in each of the genes studied. We postulate that the high diversity and circulation of multiple haplotypes has the potential of making a Pfceltos-subunit vaccine ineffective, while the low genetic diversity of Pfrh5 gene substantiates its evolutionary conservation and potential as a malaria vaccine candidate.

Prevalence and risk factors associated with malaria infection in children under two years of age in southern Togo prior to perennial malaria chemoprevention implementation

BackgroundMalaria remains the leading cause of mortality and morbidity in young children in sub-Saharan Africa. To prevent malaria in children living in moderate-to-high malaria transmission areas, the World Health Organization has recommended perennial malaria chemoprevention (PMC). Prior to piloting PMC implementation in southern Togo, a household survey was conducted to estimate malaria infection prevalence in children under 2 years of age (U2).MethodsA cross-sectional community-based household survey was conducted in the Haho district in the Togo Plateaux region. A three-stage random sampling method was used to select study participants aged 10–23 months whose caretakers gave informed consent. The prevalence of Plasmodium infection, defined as a positive rapid diagnostic test (RDT), was estimated with 95% confidence interval (CI). Clinical malaria was defined as having a positive RDT plus fever (≥ 37.5 °C) or history of fever in the last 24 h. Mixed-effects logistic regression models were used to assess the child’s, caretaker’s, and household’s factors associated with malaria infection.ResultsA total of 685 children were included in the survey conducted January–February in 2022 (dry season). Median age was 17 months (interquartile range: 13–21). About 80% of the children slept under a bed net the night before the interview. Malaria infection prevalence was 32.1% (95% CI 27.7–37.0) with significant area variation (cluster range: 0.0–73.3). Prevalence of clinical malaria was 15.4% (95% CI 12.2–19.2). Children whose caretakers were animist (aOR: 1.71, 95% CI 1.19–2.46) and those living in mother-headed households (aOR: 2.39, 95% CI 1.43–3.99) were more likely to have a positive RDT. Living more than 5 km away from the nearest health facility (aOR: 1.60, 95% CI 1.04–2.44) and presence of two or more under-5-years children in the household (aOR: 1.44, 95% CI 1.01–2.07) were also associated with increased risk of infection.ConclusionOne-third of the children U2 who participated in this survey had malaria infection, thus PMC could be a promising strategy to reduce malaria burden in young children in Plateaux region. Reinforcement of outreach services and targeting the poorest households should be prioritized to reduce the inequity in malaria prevention in children exposed to the infection.

Advanced metallothionein profile in children with malaria infection

Background: Malaria is a leading cause of death in sub-Sahara Africa including Nigeria. The oxidative stress associated with malaria infection may affect the plasma protective proteins and trace elements which participate in the antioxidant defensive system. Aim: The aim of this study was to assess the Advanced Metallothionein Profile (AMP) of malaria infected children in Benin metropolis and determine its association with parasite density. Methods: This case-control study had a total of 350 children between 6 months and 11 years with two hundred malaria positive children as case and 150 malaria negative children as control. Socio-demographic data was obtained through a semi-structured questionnaire. Blood samples were taken from participants to determine malaria parasite density using thick film microscopy. Serum Metallothionein (MT), Glutathione (GSH) and Ceruloplasmin (CP) were analyzed using Enzyme linked Immunosorbent assay (ELISA) techniques, while copper (Cu) and Zinc (Zn) levels were determined using Atomic Absorption spectrometry (AAS). The data were analyzed using appropriate statistical tools.

Trends in clinical features and severity of Plasmodium vivax malaria among children at tertiary care center in North India.

Malaria is a significant cause of morbidity and mortality in adults and children. Plasmodium falciparum is the primary cause of severe malaria, but recently Plasmodium vivax is also recognized to cause severe malaria-associated morbidity and mortality. The study focuses on determining the mortality related to severity parameters in individuals under 12 years and their critical presentation in P.vivax malaria-infected children. A prospective cross-sectional hospital-based study was conducted at Safdarjung Hospital, New Delhi, and ICMR-NIMR, New Delhi. All clinically suspected cases were admitted for screening. Exclusion criteria (rapid malaria antigen test, microscopy and medication history) were applied to all the admitted patients (n = 221) to obtain P.vivax patients only. Patients aged ≤ 12 years were included in the study. DNA was extracted from dried blood spots and amplified by nested PCR, followed by visualization on gel electrophoresis. A total of 221 clinically suspected cases of malaria were screened for P.vivax. After implementing various exclusion criteria, 45/221 cases were enrolled for the study, among which 44.4% (20/45) of children had the symptoms of severe malaria in terms of cerebral malaria, thrombocytopenia, anemia, pancytopenia, acute respiratory distress syndrome and hemophagocytic lymphohistiocytosis. Plasmodium vivax mono-infection can cause severe manifestation and must be treated as P.falciparum without any delay because it may lead to increased morbidity and mortality. A changing trend in clinical symptoms has shown in P.vivax which was an earlier phenomenon of P.falciparum.

Effects of uncomplicated malaria parasitaemia on selected haematological parameters and phagocytes of children living in Port Harcourt, Southern Nigeria

This cross-sectional and case control study evaluated the effects of malaria parasites on selected haematological parameters of children living in Port Harcourt, Nigeria. A total of 352 participants were randomly recruited and their blood samples collected. Malaria diagnosis and estimation of haematological parameters were determined using standard parasitological and haematological methods respectively. Sociodemographics of participants showed that 109 (31%) of female children and 106 (30%) of male children were infected with malaria parasites. Overall prevalence of Plasmodium falciparum found was 215(61%). The study found a statistically significant difference in the mean values of packed cell volume (PCV), haemoglobin concentration (Hb), and white blood cell count (WBC) of Plasmodium parasitized children compared with their matched controls: PCV(34.83±2.76% versus 36.06±1.41%; P=0.001); Hb(11.58±0.92g/dL versus 11.98±0.46g/dL; P=0.001); WBC (8.96±4.56(x109/L) versus 7.33±1.39(x109/L); P=0.001).While the mean values of lymphocyte counts were relatively reduced in malaria infected children than their control participants (41.66±13.57(x109/L) versus 42.95±8.36(x109/L); P=0.27). A weak relationship was found to exist between density of parasitaemia and ages of children infected with malaria parasites (R2=0.0093; P=0.1584). Though more children had low parasitaemia (1-999 parasites/μL), followed with high parasitaemia (&gt;10,000 parasites/μL), while few had moderate parasitaemia (1000-9999 parasites/μL). There was no case of complication with respect to WHO standard which described complicated or severe anaemia in malaria as haemoglobin (Hb) of &lt; 5g/dl or packed cell volume (PCV) of &lt; 15% with parasitemia of &gt; 250,000 parasites/μL. Malaria parasites affect outcomes of some haematological parameters. We recommend that all febrile children in our study area should be tested for malaria parasites in conjunction with estimation of their full blood count for effective malaria diagnosis and treatment particularly in sub patent cases.

Permethrin-treated baby wraps for the prevention of malaria in children: Protocol for a double-blind, randomized placebo-controlled controlled trial in western Uganda.

This article details the study protocol for a double-blind, randomized placebo-controlled trial to determine the effectiveness of permethrin-treated baby wraps to prevent Plasmodium falciparum malaria infection in children 6-24 months of age. Participating mother-infant dyads will be randomized to receive either a permethrin-treated or a sham-treated wrap, known locally as a "lesu." After a baseline home visit, during which time all participants will receive new long-lasting insecticidal nets, participants will attend scheduled clinic visits every two weeks for a period of 24 weeks. In the event of an acute febrile illness or other symptoms that may be consistent with malaria (e.g., poor feeding, headache, malaise), participants will be instructed to present to their respective study clinic for evaluation. The primary outcome of interest is the incidence of laboratory-confirmed, symptomatic malaria in participating children. Secondary outcomes of interest include: (1) change in children's hemoglobin levels; (2) change in children's growth parameters; (3) prevalence of asymptomatic parasitemia in children; (4) hospitalization for malaria in children; (5) change in the mother's hemoglobin level; and (6) clinical malaria in the mother. Analyses will be conducted using a modified intent-to-treat approach, with woman-infant dyads who attend one or more clinic visits analyzed according to the arm to which they were randomly assigned. This is the first use of an insecticide-treated baby wrap for prevention of malaria in children. The study began recruitment in June 2022 and is ongoing. ClinicalTrials.gov Identifier: NCT05391230, Registered 25 May 2022.

Spatiotemporal overlapping of dengue, chikungunya, and malaria infections in children in Kenya

Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.

Assessment of Knowledge, Attitude and Practices of Malaria among mothers of patients from 5 to 15 years of age in the District Bahawalnagar, Pakistan

Background: Malaria continues to be a serious global public health and development issue. Plasmodium falciparum, the most lethal type of the malaria parasite, is responsible for the great majority of malaria-related death and morbidity in children. Aim: To ascertain malaria knowledge, attitudes, and practices among mothers of patients aged 5 to 15 in the district of Bahawalgar, Pakistan. Methods: Study Design: Cross sectional Descriptive study. Settings: The study was done at District health quarter hospital Bahawalnagar. Duration of Study: The duration of study was 9 months from October to June. A questionnaire was used to collect the data from mothers of patients visiting medical OPD. Data was analyzed with SPSS version 25. Results: Findings of the study showed that a total of 241 malaria infected children were studied, to observe their plasmodium prevalence and their parental KAP of malaria. Most common age group of children was 13-15 years among 56.0%. Female’s children were commonest as 63.9%. Most of parents 46.1% were found with intermediate education. P-vivax was P-vivax was mostly seen among 66.4% children followed by p-falciparum 17.4%, p-malariae 3.3% and Plasmodium Vivax + falciparum 12.9%. The prevalence of plasmodiums was insignificantly related to demographic characteristics, with p-values that were relatively low. Conclusion: The study concluded that plasmodium vivax was the most prevalent malarial parasite. Parents had partial knowledge regarding malaria and its treatment. Parents had good attitude and agreed to participation in its prevention. Keywords: Malaria, parents, knowledge, practice, children’s mothers

Evaluation of impact of COVID-19 pandemic on the burden and pattern of severe malaria in Nigerian children

Background: Malaria is an infectious disease caused by the protozoan Plasmodium, accounting for 36% of under-five mortality. About 4.5% of all malaria-infected children reported at least one symptom of severe malaria, with worsening outcome. COVID-19 and malaria shared similar clinical presentation in children this similarity may lead to delay in initiation of treatment for malaria, with progression from uncomplicated to severe forms and consequently high mortality. Thus, we set out to study the extent COVID-19 impacted on the burden and pattern of severe malaria. Methods: It was a retrospective study of all the children admitted into the children’s emergency room severe malaria, from March 2018 to February 2022. The data collected included the total number of admissions within the period, the month and year of admission, age, gender, the component of severe malaria that was the final diagnosis and outcome of management. Data were analysed using NCSS 9 statistical software. Results: There were 4761 admissions within the study period: males were 54.7%, subjects 1-&lt;60 months were 60.5% and pre COVID-19 period were 63.7%. The prevalence rates of severe malaria in CHER were 2.6%. Among those with severe malaria, the case fatality rate was 10.7%. Severe malarial anemia was the most common accounting for 49.2% and has predilection for the younger age. Cerebral malaria was predominantly diagnosed during the COVID-19 period. Conclusions: The prevalence of severe malaria was 2.6% and severe malaria anaemia was the most common mode of presentation while cerebral malaria was diagnosed more during the COVID-19 period.

Implication of Oxidative Stress and Antioxidant Defence Systems in Symptomatic and Asymptomatic &amp;lt;i&amp;gt;Plasmodium falciparum&amp;lt;/i&amp;gt; Malaria Infection among Children Aged 1 to 15 Years in the Mount Cameroon Area

It is known that the pathogenicity of Plasmodium induces the breakdown of haemoglobin, which leads to the induction of oxidative stress. This study aimed to identify the possible effects of oxidative stress and antioxidant defence systems in symptomatic and asymptomatic Plasmodium falciparum malaria infection in children (1 - 15 years old) in the Mount Cameroon vicinity. This cross-sectional study involved blood samples collected from 473 children and examined for malaria parasitaemia. Full blood counts were performed using an automated haemoanalyser. Serum oxidative stress status (malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and vitamin C (Vit C)) were each determined by colorimetric enzymatic assays. The prevalence of malaria parasite infection was 32.1% among the participants. Out of that, 62.5% of patients with parasitaemia were symptomatic. Anaemia prevalence increased significantly with parasite density. MDA levels were significantly higher in patients with malaria symptoms than in those without symptoms. A significant and positive correlation was detected between MDA (r = 0.831, P < 0.05), NO (r = 0.779, P < 0.05), and malaria parasite density while, a significant and negative relationship occurred between parasite density and GSH (r = ?0.763, P < 0.05) and Vit C (r = ?0.826, P < 0.05) levels, SOD (r = ?0.621, P < 0.05) and CAT (r = ?0.817, P < 0.05) activities. The SOD activity and GSH level significantly decreased (P < 0.05) with an increase in the MDA levels. These findings showed that MDA and nitric oxide levels increased both in malaria participants with or without symptoms. A similar decrease in the antioxidant defence system was observed in both symptomatic and asymptomatic patients. Therefore, there is a need to develop public health policies that encourage routine diagnosis and treatment of malaria in seemingly healthy people (asymptomatic cases), and this will play an essential role in controlling malaria in tropical countries.

The effect of malaria on childhood anemia in a quasi-experimental study of 7,384 twins from 23 Sub-Saharan African countries.

Young children in Sub-Saharan Africa (SSA), particularly those from resource-limited settings, are heavily burdened by anemia and malaria. While malaria infected children frequently become anemic (hemoglobin < 110 g/L), anemia is a strongly multifactorial disease with many other risk factors than malaria. Due to the complex and often overlapping contributors to anemia, it remains challenging to isolate the true impact of malaria on population level hemoglobin concentrations. We quantified the malaria-induced effect on hemoglobin levels in children under 5 years of age, leveraging data from 7,384 twins and other multiples, aged 6 to 59 months, from 57 nationally representative Demographic and Health Surveys (DHSs) from 23 SSA countries from 2006 to 2019. The quasi-experimental twin fixed-effect design let us minimize the impact of potential confounders that do not vary between twins. Our analyses of twins revealed a malaria-induced hemoglobin decrease in infected twins of 9 g/L (95% CI -10; -7, p<0.001). The relative risk of severe anemia was higher (RR = 3.01, 95% CI 1.79; 5.1, p<0.001) among malaria positive children, compared to malaria negative children. Conversely, malaria positive children are only half as likely to be non-anemic (RR = 0.51, 95% CI 0.43; 0.61, p<0.001). Even after rigorous control for confounding through a twin fixed-effects study design, malaria substantially decreased hemoglobin levels among SSA twins, rendering them much more susceptible to severe anemia. This effect reflects the population-level effect of malaria on anemia.

Assessment of Knowledge, Attitude and Practices of Malaria among Mothers of patients between 5 and 15 Years of age

Background: Malaria continues to be a serious global public health and development issue. Plasmodium falciparum, the most lethal type of the malaria parasite, is responsible for the great majority of malaria-related death and morbidity in children. Aim: To ascertain malaria knowledge, attitudes, and practices among mothers of patients aged 5 to 15 in Bahawalgar District, Pakistan. Methods: The Cross sectional Descriptive study was done at District health quarter hospital Bahawalnagar. A questionnaire was used to collect the data from mothers of patients visiting medical OPD. Data was analyzed with SPSS version 25. Results: Findings of the study showed that a total of 241 malaria infected children were studied, to observe their plasmodium prevalence and their parental KAP of malaria. Most common age group of children was 13-15 years among 56.0%. Female’s children were commonest as 63.9%. Most of parents 46.1% were found with intermediate education. P-vivax was P-vivax was mostly seen among 66.4% children followed by p-falciparum 17.4%, p-malariae 3.3% and Plasmodium Vivax + falciparum 12.9%. The prevalence of plasmodiums was insignificantly related to demographic characteristics, with p-values that were relatively low. Conclusion: The study concluded that plasmodium vivax was the most prevalent malarial parasite. Parents had partial knowledge regarding malaria and its treatment. Parents had good attitude and agreed to participation in its prevention. Key words: Malaria, parents, knowledge, practice, children’s mothers

Effects of Malaria and HIV Infection on Anemia and T-cells Levels in Children in Douala City, Cameroon.

Introduction Human immunodeficiency virus (HIV) infection and malaria are priority health issues for sub-Saharan Africa. Both diseases worsen each other through their effect on the immune and hematological systems. This study aimed to determine the effects of HIV infection and asymptomatic malaria on anemia and T-cells counts in children in the city of Douala in the republic of Cameroon. Method From May to November 2016, 197 HIV infected and 98 HIV-free non-febrile children up to 19 years old(128 male and 167 female) participated in the study. All HIV-infected children were receiving antiretroviral treatment and co-trimoxazole. Malaria diagnosis was performed using Giemsa-stained thick blood film; immunological and hematological parameters were assessed through a flow cytometer and an automated analyzer respectively. Chi-squared or Fischer's exact tests was used to compare the proportions, Mann-Whitney and ANOVA tests were used for the means. Statistical significance was set at p˂0.05. Results The prevalence of malaria was 8.8%, and that of anemia was 40.7%. CD4+-T cells were higher in malaria-infected children, both in HIV positive and negative (p=0.049). No significant association was found between malaria parasitemia and CD8+-T cell levels, both in HIV-positive and negative children (p=0.41). Anemia was higher in HIV-positive children (p=0.019), especially in those with severe immunosuppression (p=0.001) and in younger children (p=0.0083).Children on HIV treatment presented lower malaria prevalence (8.6% versus 10.10%), though the difference was not significant (p=0.7068). Malaria infection was associated with lower hemoglobin levels (10.5±1.7 versus 11.2±1.4; p=0.016). Conclusion Malaria infection may enhance CD4+-T cells. Both malaria and HIV infection lead to a drop in hemoglobin levels. The HIV treatment protocol may reduce malaria prevalence.

Correlation of parasite density and biochemical parameters in children with malaria infection in Calabar, South-South Nigeria

BackgroundMalaria parasitemia is associated with premature, excessive hemolysis, induction of oxidative stress, and derangement in metabolism of iron, proteins, and some electrolytes. This study aims to evaluate the effects of malaria infection on ascorbic acid (AA), uric acid (UA), iron, transferrin, albumin, total iron-binding capacity (TIBC), calcium, and magnesium levels in malaria infection.ResultsAmong the 50 malaria-infected children, 12 had severe parasitemia (PD ≥ 10,000 parasites/μl), 16 had moderate parasitemia (PD: 2000 to < 10,000 parasites/μl), and 22 children had mild parasitemia (PD < 2000 parasites/μl). The AA, iron, transferrin, and TIBC levels were significantly lower and UA and Mg higher in malaria-infected children compared with the controls. Ascorbic acid correlated negatively with UA and PD in malaria-infected children. Iron correlated positively with albumin, transferrin, and TIBC in malaria-infected children, while Ca correlated negatively with Mg levels.ConclusionMalaria infection in children is associated with reduced AA and iron parameters and increased UA and Mg levels; hence, vitamin C and iron supplementation could be useful in malaria therapy.