Katte Jean-Claude, Penanje Kiya, Agoons Batakeh B, Djahmeni Eric Noel, Mbacham-Ngwafor Sharon, Moor Vicky Jocelyne Ama, Koki Paul, Mbacham Wilfred
Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon.
National Obesity Centre and Endocrinology and Metabolic Diseases Unit, Yaounde Central Hospital, Yaounde, Cameroon.
Trop Dis Travel Med Vaccines. 2022 Mar 15;8(1):5. doi: 10.1186/s40794-022-00163-9.
Procalcitonin is an inflammatory marker strongly associated with the presence of bacterial infection. It has been considered raised in severe malaria infection as opposed to uncomplicated malaria. There are suggestions that it may be raised only when there is concomitant unnoticeable bacterial infection during a malaria crisis. We aimed to assess the difference in plasma procalcitonin levels between children affected by severe and uncomplicated malaria.
We assessed plasma procalcitonin levels in 83 children diagnosed with malaria with no clinical and biological evidence of concomitant bacterial infection. Severity of malaria was established using WHO guidelines. Procalcitonin was determined using the ELISA method. Non-parametric Mann-Whitney U test was used to compare medians across the 2 groups. Statistical significance was set for all p values < 0.05.
Of the 83 participants, 28 had uncomplicated malaria, and 55 had severe malaria. PCT levels were obtained in 24 and 40 subjects of each group, respectively, and were similar in both groups; [2.76 (2.52-2.93) vs 2.74 (2.52-2.98) ng/ml, p = 0.916]. The parasite density was lower in the uncomplicated malaria group than in the severe malaria group, but not statistically significant; [22,192 (9110-44 654) vs 31 684 (13 960-73 500) parasites/μl, p = 0.178]. There was no correlation between the parasite density in the general study population and PCT levels (r = 0.072, p = 0.572).
In the absence of overt bacterial infection, procalcitonin levels are not different between children affected with uncomplicated malaria and those with severe malaria. Therefore, bacterial infection should be thoroughly checked for in children with raised serum procalcitonin diagnosed with severe malaria.
降钙素原是一种与细菌感染密切相关的炎症标志物。与非重症疟疾相比，它在重症疟疾感染中被认为会升高。有观点认为，只有在疟疾发作期间伴有未被察觉的细菌感染时，它才可能升高。我们旨在评估重症疟疾患儿和非重症疟疾患儿血浆降钙素原水平的差异。
我们评估了83名被诊断为疟疾且无合并细菌感染临床和生物学证据的儿童的血浆降钙素原水平。根据世界卫生组织指南确定疟疾的严重程度。采用酶联免疫吸附测定法测定降钙素原。使用非参数曼-惠特尼U检验比较两组的中位数。所有p值<0.05时具有统计学意义。
83名参与者中，28例为非重症疟疾，55例为重症疟疾。每组分别有24名和40名受试者获得了降钙素原水平，两组相似；[2.76（2.52 - 2.93）对2.74（2.52 - 2.98）ng/ml，p = 0.916]。非重症疟疾组的寄生虫密度低于重症疟疾组，但无统计学意义；[22,192（9110 - 44 654）对31 684（13 960 - 73 500）个寄生虫/μl，p = 0.178]。总体研究人群中的寄生虫密度与降钙素原水平之间无相关性（r = 0.072，p = 0.572）。
在无明显细菌感染的情况下，非重症疟疾患儿和重症疟疾患儿的降钙素原水平无差异。因此，对于诊断为重症疟疾且血清降钙素原升高的儿童，应彻底检查是否存在细菌感染。
