Ehiem Raymond Charles, Nanse Fareed Arthur Kow, Adu-Frimpong Michael, Mills-Robertson Felix Charles
Saint Patrick's Hospital, Offinso, Kumasi, Ghana.
Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Heliyon. 2021 Jun 30;7(7):e07445. doi: 10.1016/j.heliyon.2021.e07445. eCollection 2021 Jul.
Malaria is an important global health disease which puts individuals, particularly children, at a greater risk of mortality. is distinguished from the rest of the by its high level of parasitaemia. They infect liver cells (hepatocytes), and multiply into merozoites and rupture liver cells in the process, prior to infection of red blood cells. This study sought to estimate the extent to which parasitaemia correlates with hepatocellular dysfunction among Ghanaian children suffering from acute malaria in three malaria endemic districts in Ashanti Region and to predict liver dysfunction from the estimation of haemoglobin (HB) levels. A prospective uncontrolled before- and after study was conducted among under five years children with acute malaria (n = 300) and a control group (n = 20) within the same age brackets. The serum activities of liver enzymes such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) were measured in patients and control subjects. The study observed an inverse relationship between mean HB and parasitaemia (mean HB level of 10.34 ± 0.14 versus parasitaemia <10,000 parasites/μL as against 8.06 ± 0.16 versus parasitaemia ≥10,000 parasites/μL). The mean levels of AST, ALT, ALP and GGT were higher ( < 0.0001) in the serum of the infected children before treatment compared with post treatment. Moreover, the receiver operating characteristics (ROC) curve was applied to establish that HB level at 10.9 g/dL predicted liver dysfunction with the area under the curve (AUC) being 0.75 ± 0.03 (P < 0.0001). The parasitaemia estimation and prediction of hepatocellular dysfunction in Ghanaian children with acute malaria could be done via HB levels.
疟疾是一种重要的全球健康疾病，它使个人尤其是儿童面临更高的死亡风险。它与其他疾病的区别在于其高水平的寄生虫血症。疟原虫感染肝细胞（肝细胞），并在感染红细胞之前繁殖成裂殖子并在此过程中使肝细胞破裂。本研究旨在评估在阿散蒂地区三个疟疾流行区患有急性疟疾的加纳儿童中，疟原虫血症与肝细胞功能障碍的相关程度，并通过估计血红蛋白（HB）水平来预测肝功能障碍。对300名患有急性疟疾的5岁以下儿童和同一年龄段的20名对照组儿童进行了一项前瞻性非对照前后研究。在患者和对照受试者中测量了血清肝酶如天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、碱性磷酸酶（ALP）和γ-谷氨酰转移酶（GGT）的活性。该研究观察到平均HB与疟原虫血症之间存在负相关关系（平均HB水平为10.34±0.14，疟原虫血症<10,000个寄生虫/μL，而疟原虫血症≥10,000个寄生虫/μL时为8.06±0.16）。与治疗后相比，感染儿童治疗前血清中AST、ALT、ALP和GGT的平均水平更高（P<0.0001）。此外，应用受试者工作特征（ROC）曲线确定，HB水平为10.9 g/dL时可预测肝功能障碍，曲线下面积（AUC）为0.75±0.03（P<0.0001）。加纳急性疟疾儿童的疟原虫血症估计和肝细胞功能障碍预测可通过HB水平进行。
