Parasitology Unit, Department of Zoology, University of Ilorin, Ilorin, Nigeria.
Department of Biology, Federal University of Technology, Akure, Nigeria.
Acta Parasitol. 2024 Mar;69(1):514-525. doi: 10.1007/s11686-023-00781-z. Epub 2024 Jan 13.
The study attempted to identify possible overlap between serum cell-reactive proteins (C-rp) and hematological indices as predictors of comorbidity of malaria and septicemia among children attending primary healthcare facilities in Ilorin, Nigeria.
One hundred and ninety-three children (aged: ≤ 1-15 years) presenting with symptoms suggestive of malaria were enrolled. Blood specimens were collected and screened for: Romanowsky, culture, serum C-RP and hematological indices.
One hundred and fifteen (59.6%) children had Plasmodium falciparum infections (female 69.0% and male 34.1%). Septicemia was common among 52 (26.9%), but malaria and septicemia co-infection was 42 (36.5%). C-rp levels were low (< 10 mg/L) in 41 (35.7%, OR 4.594, CI 2.463-8.571) and high (> 10 mg/L) in 74 (64.3%, OR 2.519, CI 1.681-3.775) among the malaria positives (p < 0.05). Children with low C-rp, 8 (15.4%, OR 9.413, CI 4.116-21.531) were positive for septicemia and high C-RP 44 (84.6%, OR 1.694, CI 1.396-2.055), but without malaria, respectively. Similarly, increased C-rp levels were significantly associated with clinical malaria; > 10,000 parasites/μL (OR 1.486, CI 1.076-2.054, P < 0.001). Malaria-positive versus negative showed that PCV, C-rp, hemoglobin, platelet, WBC, and neutrophil were statistically significant (P < 0.05). Two bacteria species were identified, viz; Staphylococcus aureus 39 (54.9%) and Escherichia coli 32 (45.1%). The trade-off between sensitivity and specificity occurred at 16.475 cut-off using C-rp and degree of malaria severity as the standard for AUROC.
C-rp are inflammatory markers, though non-specificity may be associated with malaria prognosis and severity during malaria-septicemia co-infection.
本研究旨在确定血清细胞反应蛋白（C-rp）和血液学指标之间是否存在重叠，以预测尼日利亚伊洛林初级保健机构就诊的儿童疟疾和败血症合并症的发生。
共纳入 193 名出现疑似疟疾症状的儿童（年龄：≤1-15 岁）。采集血样并进行罗氏染色、培养、血清 C-RP 和血液学指标检测。
115 名（59.6%）儿童患有恶性疟原虫感染（女性占 69.0%，男性占 34.1%）。52 名（26.9%）儿童患有败血症，而疟疾和败血症合并感染的有 42 名（36.5%）。C-rp 水平较低（<10mg/L）的疟疾阳性者有 41 名（35.7%，OR 4.594，CI 2.463-8.571），C-rp 水平较高（>10mg/L）的有 74 名（64.3%，OR 2.519，CI 1.681-3.775）（p<0.05）。C-rp 水平较低的儿童中，8 名（15.4%，OR 9.413，CI 4.116-21.531）呈败血症阳性，C-rp 水平较高的儿童中，44 名（84.6%，OR 1.694，CI 1.396-2.055）呈败血症阳性，且无疟疾。同样，C-rp 水平升高与临床疟疾显著相关；>10,000 个寄生虫/μL（OR 1.486，CI 1.076-2.054，P<0.001）。疟疾阳性与阴性相比，PCV、C-rp、血红蛋白、血小板、白细胞和中性粒细胞有统计学意义（P<0.05）。鉴定出两种细菌，分别是金黄色葡萄球菌 39 株（54.9%）和大肠杆菌 32 株（45.1%）。以 C-rp 和疟疾严重程度为标准，使用 AUROC 计算得出，C-rp 为 16.475 时，灵敏度和特异性之间存在折衷。
C-rp 是炎症标志物，尽管其非特异性可能与疟疾合并败血症的疟疾预后和严重程度有关。
