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Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

Impact of asymptomatic Plasmodium falciparum parasitemia on the imunohematological indices among school children and adolescents in a rural area highly endemic for Malaria in southern Mozambique

Authors: Eduardo Samo Gudo, António Prista, Ilesh V Jani

Published in: BMC Infectious Diseases | Issue 1/2013

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Abstract

Background

Asymptomatic Plasmodium falciparum parasitemia (APFP) has been reported to be highly prevalent in Sub-Saharan Africa, a region heavily burdened by malaria, yet, the impact of APFP on the immunological reference values have not yet been established. This study was aimed at i) determine the prevalence of APFP in children and adolescents living in a region highly endemic for malaria in southern Mozambique and its impact on the immuno-hematological indices and ii) determine the factors independently associated with APFP.

Methods

A cross sectional study was conducted in a rural area highly endemic for Malaria in southern Mozambique during the dry season. Apparently healthy children and adolescents were selected for the study.

Results

Blood samples were collected from 348 participants. Plasmodium falciparum was detected in 56.5% (194/343) of study subjects. APFP was more frequent in males and was associated with lower values of hemoglobin and platelets measurements. Parasitized and not parasitized individuals were similar in terms of lymphocyte counts, CD4+ and CD8+ T cells counts. Platelet count was the parameter with strongest association with APFP (OR: 0.991, p= 0.000) in children and its performance in guiding clinical suspicion was moderate (AUC: 0.70, p=0.000). Contrarily, in adolescents, the predictive value of platelets counts was low (AUC: 0.55).

Conclusion

Overall, our finding demonstrated that APFP is highly prevalent in regions endemic for malaria in southern Mozambique and was associated with lower hematological parameters but unaltered lymphocyte counts, CD4+ and CD8+ T cells counts. Platelets count was of moderate performance in guiding clinical suspicion of APFP in children but not in adolescents.
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Literature
1.
go back to reference Baliraine FN, Afrane YA, Amenya DA, Bonizzoni M, Menge DM, Zhou G, Zhong D, Vardo-Zalik AM, Githeko AK, Yan G: High prevalence of asymptomatic plasmodium falciparum infections in a highland area of western Kenya: a cohort study. J Infect Dis. 2009, 200: 66-74. 10.1086/599317.CrossRefPubMedPubMedCentral Baliraine FN, Afrane YA, Amenya DA, Bonizzoni M, Menge DM, Zhou G, Zhong D, Vardo-Zalik AM, Githeko AK, Yan G: High prevalence of asymptomatic plasmodium falciparum infections in a highland area of western Kenya: a cohort study. J Infect Dis. 2009, 200: 66-74. 10.1086/599317.CrossRefPubMedPubMedCentral
2.
go back to reference Njama-Meya D, Kamya MR, Dorsey G: Asymptomatic parasitaemia as a risk factor for symptomatic malaria in a cohort of Ugandan children. Trop Med Int Health. 2004, 9: 862-868. 10.1111/j.1365-3156.2004.01277.x.CrossRefPubMed Njama-Meya D, Kamya MR, Dorsey G: Asymptomatic parasitaemia as a risk factor for symptomatic malaria in a cohort of Ugandan children. Trop Med Int Health. 2004, 9: 862-868. 10.1111/j.1365-3156.2004.01277.x.CrossRefPubMed
3.
go back to reference Dal-Bianco MP, Koster KB, Kombila UD, Kun JF, Grobusch MP, Ngoma GM, Matsiegui PB, Supan C, Salazar CL, Missinou MA, et al: High prevalence of asymptomatic plasmodium falciparum infection in gabonese adults. AmJTrop Med Hyg. 2007, 77: 939-942. Dal-Bianco MP, Koster KB, Kombila UD, Kun JF, Grobusch MP, Ngoma GM, Matsiegui PB, Supan C, Salazar CL, Missinou MA, et al: High prevalence of asymptomatic plasmodium falciparum infection in gabonese adults. AmJTrop Med Hyg. 2007, 77: 939-942.
4.
go back to reference Bottius E, Guanzirolli A, Trape JF, Rogier C, Konate L, Druilhe P: Malaria: even more chronic in nature than previously thought; evidence for subpatent parasitaemia detectable by the polymerase chain reaction. Trans R Soc Trop Med Hyg. 1996, 90: 15-19. 10.1016/S0035-9203(96)90463-0.CrossRefPubMed Bottius E, Guanzirolli A, Trape JF, Rogier C, Konate L, Druilhe P: Malaria: even more chronic in nature than previously thought; evidence for subpatent parasitaemia detectable by the polymerase chain reaction. Trans R Soc Trop Med Hyg. 1996, 90: 15-19. 10.1016/S0035-9203(96)90463-0.CrossRefPubMed
5.
go back to reference Mabunda S, Aponte JJ, Tiago A, Alonso P: A country-wide malaria survey in Mozambique, II. Malaria attributable proportion of fever and establishment of malaria case definition in children across different epidemiological settings. Malar J. 2009, 8: 74-10.1186/1475-2875-8-74.CrossRefPubMedPubMedCentral Mabunda S, Aponte JJ, Tiago A, Alonso P: A country-wide malaria survey in Mozambique, II. Malaria attributable proportion of fever and establishment of malaria case definition in children across different epidemiological settings. Malar J. 2009, 8: 74-10.1186/1475-2875-8-74.CrossRefPubMedPubMedCentral
6.
go back to reference Maina RN, Walsh D, Gaddy C, Hongo G, Waitumbi J, Otieno L, Jones D, Ogutu BR: Impact of Plasmodium falciparum infection on haematological parameters in children living in Western Kenya. Malar J. 2010, 9 (Suppl 3): S4-10.1186/1475-2875-9-S3-S4.CrossRefPubMedPubMedCentral Maina RN, Walsh D, Gaddy C, Hongo G, Waitumbi J, Otieno L, Jones D, Ogutu BR: Impact of Plasmodium falciparum infection on haematological parameters in children living in Western Kenya. Malar J. 2010, 9 (Suppl 3): S4-10.1186/1475-2875-9-S3-S4.CrossRefPubMedPubMedCentral
7.
go back to reference Albaran RG, Webber J, Steffes CP: CD4 cell counts as a prognostic factor of major abdominal surgery in patients infected with the human immunodeficiency virus. Arch Surg. 1998, 133: 626-631. 10.1001/archsurg.133.6.626.CrossRefPubMed Albaran RG, Webber J, Steffes CP: CD4 cell counts as a prognostic factor of major abdominal surgery in patients infected with the human immunodeficiency virus. Arch Surg. 1998, 133: 626-631. 10.1001/archsurg.133.6.626.CrossRefPubMed
8.
go back to reference Bergquist PL, Hardiman EM, Ferrari BC, Winsley T: Applications of flow cytometry in environmental microbiology and biotechnology. Extremophiles. 2009, 13: 389-401. 10.1007/s00792-009-0236-4.CrossRefPubMed Bergquist PL, Hardiman EM, Ferrari BC, Winsley T: Applications of flow cytometry in environmental microbiology and biotechnology. Extremophiles. 2009, 13: 389-401. 10.1007/s00792-009-0236-4.CrossRefPubMed
9.
go back to reference Erhabor O, Uko EK, Adias T: Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating antiretroviral therapy in HIV infected Nigerians. Niger J Med. 2006, 15: 56-59.PubMed Erhabor O, Uko EK, Adias T: Absolute lymphocyte count as a marker for CD4 T-lymphocyte count: criterion for initiating antiretroviral therapy in HIV infected Nigerians. Niger J Med. 2006, 15: 56-59.PubMed
10.
go back to reference Huh YO, Huck L: Oncology applications of flow cytometry. Clin Lab Sci. 1992, 5: 25-27.PubMed Huh YO, Huck L: Oncology applications of flow cytometry. Clin Lab Sci. 1992, 5: 25-27.PubMed
11.
go back to reference Oliveira JB, Notarangelo LD, Fleisher TA: Applications of flow cytometry for the study of primary immune deficiencies. Curr Opin Allergy Clin Immunol. 2008, 8: 499-509. 10.1097/ACI.0b013e328312c790.CrossRefPubMed Oliveira JB, Notarangelo LD, Fleisher TA: Applications of flow cytometry for the study of primary immune deficiencies. Curr Opin Allergy Clin Immunol. 2008, 8: 499-509. 10.1097/ACI.0b013e328312c790.CrossRefPubMed
13.
go back to reference WHO: Antiretroviral therapy for hiv infection in infants and children: towards universal access: Recommendations for a public health approach. 2010, Geneva: WHO Library WHO: Antiretroviral therapy for hiv infection in infants and children: towards universal access: Recommendations for a public health approach. 2010, Geneva: WHO Library
14.
go back to reference Gudo ES, Prista A, Jani I: Immunohematological indices among school children and adolescents living in Manhiça district. 2012, Mozambique, Maputo: Revista Científica da Universidade Eduardo Mondlane Gudo ES, Prista A, Jani I: Immunohematological indices among school children and adolescents living in Manhiça district. 2012, Mozambique, Maputo: Revista Científica da Universidade Eduardo Mondlane
15.
go back to reference Nhantumbo L, Maia J, Saranga S, Prista A: Physical activity among children and adolescents in a rural community in Mozambique: effects of age, sex, and nutritional status. Rev Panam Salud Publica. 2008, 23: 171-178.CrossRefPubMed Nhantumbo L, Maia J, Saranga S, Prista A: Physical activity among children and adolescents in a rural community in Mozambique: effects of age, sex, and nutritional status. Rev Panam Salud Publica. 2008, 23: 171-178.CrossRefPubMed
16.
go back to reference Payne D: Use and limitations of light microscopy for diagnosing malaria at the primary health care level. Bull World Health Organ. 1988, 66: 621-626.PubMedPubMedCentral Payne D: Use and limitations of light microscopy for diagnosing malaria at the primary health care level. Bull World Health Organ. 1988, 66: 621-626.PubMedPubMedCentral
17.
go back to reference Mandy FF, Nicholson JK, McDougal JS, Centers for Disease Control and Prevention: Guidelines for performing single-platform absolute CD4+ T-cell determinations with CD45 gating for persons infected with human immunodeficiency virus. MMWR Recomm Rep. 2003, 52: 1-13.PubMed Mandy FF, Nicholson JK, McDougal JS, Centers for Disease Control and Prevention: Guidelines for performing single-platform absolute CD4+ T-cell determinations with CD45 gating for persons infected with human immunodeficiency virus. MMWR Recomm Rep. 2003, 52: 1-13.PubMed
18.
go back to reference WHO, CDC: Worldwide prevalence of anaemia 1993–2005. 2008, Geneva: WHO Library WHO, CDC: Worldwide prevalence of anaemia 1993–2005. 2008, Geneva: WHO Library
19.
go back to reference Steenkeste N, Rogers WO, Okell L, Jeanne I, Incardona S, Duval L, Chy S, Hewitt S, Chou M, Socheat D, et al: Sub-microscopic malaria cases and mixed malaria infection in a remote area of high malaria endemicity in Rattanakiri province, Cambodia: implication for malaria elimination. Malar J. 2010, 9: 108-10.1186/1475-2875-9-108.CrossRefPubMedPubMedCentral Steenkeste N, Rogers WO, Okell L, Jeanne I, Incardona S, Duval L, Chy S, Hewitt S, Chou M, Socheat D, et al: Sub-microscopic malaria cases and mixed malaria infection in a remote area of high malaria endemicity in Rattanakiri province, Cambodia: implication for malaria elimination. Malar J. 2010, 9: 108-10.1186/1475-2875-9-108.CrossRefPubMedPubMedCentral
20.
go back to reference Oertelt-Prigione S: The influence of sex and gender on the immune response. Autoimmun Rev. 2012, 11: A479-485. 10.1016/j.autrev.2011.11.022.CrossRefPubMed Oertelt-Prigione S: The influence of sex and gender on the immune response. Autoimmun Rev. 2012, 11: A479-485. 10.1016/j.autrev.2011.11.022.CrossRefPubMed
21.
go back to reference Bouman A, Heineman MJ, Faas MM: Sex hormones and the immune response in humans. Hum Reprod Update. 2005, 11: 411-423. 10.1093/humupd/dmi008.CrossRefPubMed Bouman A, Heineman MJ, Faas MM: Sex hormones and the immune response in humans. Hum Reprod Update. 2005, 11: 411-423. 10.1093/humupd/dmi008.CrossRefPubMed
22.
go back to reference Augusto G, Nala R, Casmo V, Sabonete A, Mapaco L, Monteiro J: Geographic distribution and prevalence of schistosomiasis and soil-transmitted helminths among schoolchildren in Mozambique. AmJTrop Med Hyg. 2009, 81: 799-803. 10.4269/ajtmh.2009.08-0344.CrossRef Augusto G, Nala R, Casmo V, Sabonete A, Mapaco L, Monteiro J: Geographic distribution and prevalence of schistosomiasis and soil-transmitted helminths among schoolchildren in Mozambique. AmJTrop Med Hyg. 2009, 81: 799-803. 10.4269/ajtmh.2009.08-0344.CrossRef
23.
go back to reference Gouagna LC, Okech BA, Kabiru EW, Killeen GF, Obare P, Ombonya S, Bier JC, Knols BG, Githure JI, Yan G: Infectivity of Plasmodium falciparum gametocytes in patients attending rural health centres in western Kenya. East Afr Med J. 2003, 80: 627-634.PubMed Gouagna LC, Okech BA, Kabiru EW, Killeen GF, Obare P, Ombonya S, Bier JC, Knols BG, Githure JI, Yan G: Infectivity of Plasmodium falciparum gametocytes in patients attending rural health centres in western Kenya. East Afr Med J. 2003, 80: 627-634.PubMed
24.
go back to reference Gerardin P, Rogier C, Ka AS, Jouvencel P, Brousse V, Imbert P: Prognostic value of thrombocytopenia in African children with falciparum malaria. AmJTrop Med Hyg. 2002, 66: 686-691. Gerardin P, Rogier C, Ka AS, Jouvencel P, Brousse V, Imbert P: Prognostic value of thrombocytopenia in African children with falciparum malaria. AmJTrop Med Hyg. 2002, 66: 686-691.
25.
go back to reference Lathia TB, Joshi R: Can hematological parameters discriminate malaria from nonmalarious acute febrile illness in the tropics?. Indian J Med Sci. 2004, 58: 239-244.PubMed Lathia TB, Joshi R: Can hematological parameters discriminate malaria from nonmalarious acute febrile illness in the tropics?. Indian J Med Sci. 2004, 58: 239-244.PubMed
26.
go back to reference Khan SJ, Abbass Y, Marwat MA: Thrombocytopenia as an indicator of malaria in adult population. Malar Res Treat. 2012, 405981- Khan SJ, Abbass Y, Marwat MA: Thrombocytopenia as an indicator of malaria in adult population. Malar Res Treat. 2012, 405981-
Metadata
Title
Impact of asymptomatic Plasmodium falciparum parasitemia on the imunohematological indices among school children and adolescents in a rural area highly endemic for Malaria in southern Mozambique
Authors
Eduardo Samo Gudo
António Prista
Ilesh V Jani
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-244

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