School of Basic and Biomedical Sciences, Department of Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
PLoS One. 2022 Jun 8;17(6):e0269720. doi: 10.1371/journal.pone.0269720. eCollection 2022.
In Ghana, uncomplicated malaria and sickle cell disease (SCD) is common, hence comorbidity is not farfetched. However, the extent of oxidative stress and the array of clinical manifestations in this comorbidity (presence of both malaria and SCD) has not been fully explored. This study highlights the impact of uncomplicated malaria on SCD. The level of isoprostane, 8-iso-prostaglandin F2α (8-iso-PGF2α) was used to assess oxidative stress while plasma biochemistry and urinalysis was used to assess renal function. Hematological profiling was also done to assess the impact of comorbidity on the hematological cell lines. Of the 411 study participants with malaria, 45 (11%) had SCD. Mean body temperature was significantly higher in comorbidity compared to malaria and SCD cohorts, while a lower parasite density range was obtained in comorbidity compared to malaria cohorts. Furthermore, in comorbidity, the 8-iso-PGF2α oxidative stress biomarker was significantly elevated in all ages, parasite density ranges and gender groups. Comorbidity affected both leukocytic and erythrocytic cell lines with significant eosinophilia and monocytosis coexisting with erythrocytic parameters consistent with severe anemia. Biochemically, while plasma creatinine and bilirubin were significantly elevated in comorbidity, spot urinary creatinine was significantly reduced. Additionally, urine samples in the comorbid state were slightly acidic and hypersthenuric with significant hematuria, proteinuria, and bilirubinemia. Finally, 80% or more malaria-SCD presented with chills, fever, anorexia, headache, joint pains, lethargy, and vomiting. In conclusion, malaria could induce vaso-occlusive crisis in sickle cell disease, therefore, prompt management will alleviate the severity of this comorbidity.
在加纳，疟疾和镰状细胞病（SCD）较为常见，因此合并症并不罕见。然而，这种合并症（既有疟疾又有 SCD）的氧化应激程度和临床表现范围尚未得到充分探索。本研究强调了疟疾对 SCD 的影响。使用 8-异前列腺素 F2α（8-iso-PGF2α）来评估氧化应激水平，同时使用血浆生化和尿液分析来评估肾功能。还进行了血液学分析，以评估合并症对血液学细胞系的影响。在 411 名患有疟疾的研究参与者中，有 45 名（11%）患有 SCD。与疟疾和 SCD 组相比，合并症组的平均体温明显更高，而与疟疾组相比，合并症组的寄生虫密度范围较低。此外，在合并症中，8-iso-PGF2α 氧化应激生物标志物在所有年龄、寄生虫密度范围和性别组中均显著升高。合并症影响白细胞和红细胞系，导致嗜酸性粒细胞和单核细胞明显增多，同时伴有与严重贫血一致的红细胞参数。在生化方面，虽然合并症中的血浆肌酐和胆红素显著升高，但斑点尿肌酐显著降低。此外，在合并症状态下，尿液呈微酸性且高尿酸，伴有明显血尿、蛋白尿和胆红素血症。最后，80%或更多的疟疾-SCD 表现出寒战、发热、食欲不振、头痛、关节痛、乏力和呕吐。总之，疟疾可能会在镰状细胞病中引发血管阻塞性危机，因此及时治疗将减轻这种合并症的严重程度。
