Parasite density in severe malaria in Colombia

Abstract Background Available evidence indicates that the various stages of the malaria parasite life cycle have specific immune responses. The pro-inflammatory cytokines tend to play an important role in preventing malaria and killing the parasites. Furthermore, the relative levels of pro-and anti-inflammatory cytokines are essential mediators of malaria anemia production and outcomes. Natural human immune responses to malaria recognize extracellular sporozoites and merozoites, both of which have surface-exposed antigens, and which are currently being developed for various vaccines. Methods A total of four hundred sixty- two (462) participants were tested for Plasmodium falciparum. The procedure employed were parasite staining using World Health Organization parasitology laboratory protocol [Microscopy] of Giemsa staining and Enzyme linked immunosorbent assay [ELISA]. Results The subjects in this study showed high levels of INF-γ and TNF-α which decreases with increased malaria severity and high parasite density. These results suggest that INF-γ cytokine and TNF-α may contribute to protection against severe malaria anaemia and parasite clearance. Conversely, infected participants showed higher levels of IL-10, which decreases with severe malaria parasite, furthermore IL-10 levels correlated with parasite density. These findings suggest that higher levels of anti-inflammatory cytokines, especially IL-10 levels may contribute to pathogenesis of complicated malaria by inhibiting the INF-γ and TNF-α production. Conclusion Molecular biological and other serological analysis are needed to elucidate the implication of these cytokines and other pro-inflammatory cytokines as IL-17, IL-21 and IL-22 in the responses to malaria and consequently their involvement in malaria vaccine construct/development as well as other therapeutics for the treatment and elimination of the malaria parasite in our environment.

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Age-dependent effect of plasma nitric oxide on parasite density in Ghanaian children with severe malaria

Tropical Medicine & International Health ◽

10.1111/j.1365-3156.2005.01438.x ◽

2005 ◽

Vol 10 (7) ◽

pp. 672-680 ◽

Cited By ~ 19

Author(s):

Jakob P. Cramer ◽

Andreas K. Nussler ◽

Stephan Ehrhardt ◽

Jana Burkhardt ◽

Rowland N. Otchwemah ◽

...

Keyword(s):

Nitric Oxide ◽

Severe Malaria ◽

Parasite Density ◽

Dependent Effect ◽

Age Dependent

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Early rectal artesunate is more effective at reducing parasite density compared with intramuscular quinine in people with moderately severe malaria

Evidence-based Healthcare and Public Health ◽

10.1016/j.ehbc.2004.09.010 ◽

2004 ◽

Vol 8 (6) ◽

pp. 375-376

Keyword(s):

Severe Malaria ◽

Parasite Density ◽

Rectal Artesunate

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A meta-analysis on the prevalence and characteristics of severe malaria in patients with Plasmodium spp. and HIV co-infection

Scientific Reports ◽

10.1038/s41598-021-95591-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Aongart Mahittikorn ◽

Kwuntida Uthaisar Kotepui ◽

Giovanni De Jesus Milanez ◽

Frederick Ramirez Masangkay ◽

Manas Kotepui

Keyword(s):

Severe Malaria ◽

Parasite Density ◽

Prevention And Control ◽

Meta Analysis ◽

Mortality Rates ◽

Prompt Treatment ◽

Pooled Prevalence ◽

Immunodeficiency Virus ◽

Leukocyte Counts ◽

And Control

AbstractCo-infection with malaria and human immunodeficiency virus (HIV) increases the severity and mortality rates of both diseases. A better understanding of the effects of co-infections could help in the diagnosis, prompt treatment, prevention, and control of malarial parasites among HIV-infected patients. In this systematic review and meta-analysis, we estimated the prevalence and characteristics of severe malaria (SM) caused by co-infection with HIV. We included relevant studies that were conducted between the years 1991 and 2018 and reporting on SM. We pooled the prevalence of SM in patients with co-infection, pooled odds ratios of SM in patients with co-infection and Plasmodium mono-infection, and differences in laboratory parameters such as parasite density and leucocyte counts, between co-infected and Plasmodium mono-infected patients. The meta-analysis included 29 studies (1126 SM cases). The pooled prevalence of SM in co-infected patients using the data of 23 studies (SM = 795 cases, all co-infection cases = 2534 cases) was 43.0% (95% confidence interval [CI] 31.0–56.0%; I2, 98.0%). Overall, the odds of SM from 18 studies were pooled. The odds of SM were significantly higher in co-infected patients than in Plasmodium mono-infected patients (OR 2.41; 95% CI 1.43–4.08; I2 = 85%; P = 0.001) and also significantly higher in children (OR 9.69; 95% CI 5.14–18.3; I2, 0%; P < 0.0001; two studies) than in adults (OR 2.68; 95% CI 1.52–4.73; I2, 79.0%; P = 0.0007; 12 studies). Co-infected patients with SM had a higher parasite density than those with Plasmodium mono-infection when the data of seven studies were analysed (SMD, 1.25; 95% CI 0.14–2.36; I2, 98.0%; P = 0.03) and higher leukocyte counts when the data of four studies were analysed (MD, 1570 cells/µL; 95% CI 850–2300 cells/µL; I2, 21.0%; P < 0.0001). Thus, the prevalence of SM among patients co-infected with Plasmodium spp. and HIV is high. Because co-infections could lead to SM, patients with Plasmodium spp. and HIV co-infection should be identified and treated to reduce the prevalence of SM and the number of deaths.

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