Vector Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
Global Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Trans R Soc Trop Med Hyg. 2023 Nov 3;117(11):797-803. doi: 10.1093/trstmh/trad037.
Plasmodium falciparum pigment-containing leucocytes (PCLs) are associated with adverse clinical manifestations of severe malaria in African children. However, limited data exist on the association of PCLs in settings outside of Africa.
Thin films on peripheral blood slides obtained from children ages 6 months-10 y with severe malaria were examined for PCLs. The intraleucocytic pigment data were correlated with clinical phenotypic data such as severe anaemia, metabolic acidosis and coma to determine the association of PCLs with clinical phenotypes of severe malaria and outcome.
Of the 169 children with severe P. falciparum malaria confirmed by microscopy, 76% (129/169) had PCLs. Compared with children without PCLs, the presence (adjusted odds ratio [AOR] 3.2 [95% confidence interval {CI} 1.5 to 6.9], p≤0.01) and quantity (AOR 1.0 [95% CI 1.0 to 1.1], p=0.04) of pigment-containing monocytes (PCMs) was significantly associated with severe anaemia, while the quantity of both PCMs (AOR 1.0 [95% CI 1.0 to 1.1], p≤0.01) and pigment-containing neutrophils (AOR 1.0 [95% CI 1.0 to 1.1], p=0.01) was significantly associated with metabolic acidosis. Plasma P. falciparum histidine-rich protein-2 level negatively correlated with the platelet count (r=-0.5, p≤0.01) in patients with PCLs and no PCLs.
In Papua New Guinean children with severe P. falciparum malaria, the presence and quantity of PCLs are predictors of disease severity, severe anaemia and metabolic acidosis.
恶性疟原虫含色素白细胞（PCLs）与非洲儿童严重疟疾的不良临床症状有关。然而，在非洲以外地区有关 PCLs 的数据有限。
检查外周血涂片上 6 个月至 10 岁患有严重疟疾儿童的薄血膜，以确定 PCLs。将细胞内色素数据与严重贫血、代谢性酸中毒和昏迷等临床表型数据相关联，以确定 PCLs 与严重疟疾的临床表型和结局的关系。
在通过显微镜确认的 169 例严重恶性疟原虫疟疾儿童中，76%（129/169）有 PCLs。与没有 PCLs 的儿童相比，存在（校正优势比[OR] 3.2 [95%置信区间{CI} 1.5 至 6.9]，p≤0.01）和数量（OR 1.0 [95% CI 1.0 至 1.1]，p=0.04）的含色素单核细胞（PCMs）与严重贫血显著相关，而 PCMs 的数量（OR 1.0 [95% CI 1.0 至 1.1]，p≤0.01）和含色素中性粒细胞（OR 1.0 [95% CI 1.0 至 1.1]，p=0.01）与代谢性酸中毒显著相关。有和无 PCLs 的患者中，疟原虫裂殖子表面蛋白 2 水平与血小板计数呈负相关（r=-0.5，p≤0.01）。
在巴布亚新几内亚患有严重恶性疟原虫疟疾的儿童中，PCLs 的存在和数量是疾病严重程度、严重贫血和代谢性酸中毒的预测指标。
