Changes in blood counts, serum lactate dehydrogenase activity and haptoglobin level in malaria infected subjects in Nnewi, Anambra state, Nigeria
DOI:
https://doi.org/10.18203/2320-6012.ijrms20202887Keywords:
Blood counts, Haptoglobin, Lactate dehydrogenase, Malaria parasiteamiaAbstract
Background: Malaria is a mosquito-borne public health problem which alters the blood counts, haptoglobin level and serum lactate dehydrogenase (sLDH) activity of the infected individuals. Some of the alterations are associated risk factors in malaria pathology. This study aims at elucidating changes in blood counts, sLDH activity and haptoglobin level in malaria infected subjects seen in a Tertiary Health Institution in Nnewi, as search for associated risk factors in malaria pathology.
Methods: This cross sectional study enrolled 270 age matched subjects between 18-65 years. The test group (200) who tested positive to P. falciparium was placed into two groups based on their parasite counts with cut-off of ≥1000 parasites x 109/L. Group one (100) had counts above the cut-off and group two (100) below. The control (70) was aparasitemic. The demographic data were noted and 4mls of blood drawn. 2mls in K3EDTA was for FBC testing using Mythic 22 hematology analyzer, and remaining dispensed into plain tubes was for sLDH assay by kinetic method and haptoglobin by ELISA technique.
Results: The HCT, Hb, RBC and Platelet count of test were progressively significantly lowered (p=0.001) compared to control, with an intra-significant difference among the 3 groups (p<0.05), also the parameters were found to have an inverse significant relationship (p=0.001) to the parasite counts. This trend was also seen with haptoglobin while reverse was the case with LDH activity which rather increased significantly (p = 0.000) at opposite direction as parasite density increases.
Conclusions: This study show that the degree of intravascular haemolysis is directly influenced by the parasite density, this portends that high endemicity and perennial parasiteamia in the study area could cause chronic anaemia and thrombocytopenia in the population studied.
References
World Health Organization. world malaria report, 20 avenue Appia CH-1211 Geneva27 Available at: www.who.int/malariahttp://www.who.int/malaria/publications/world_malaria_report 2008/en/index.html, 2008, Accessed 1st November 2016.
Chandra S, Chandra H. Role of haematological parameters as an indicator of acute malarial infection in Uttarakhand state of India. Mediterranean J Hematol and Infe Dis. 2013;5(1)9-16.
Erhabor O, Mohammad HJ, Onuigue FU, Abdulrahaman Y, Ezimah AC. Anaemia and Thrombocytopenia among Malaria Parasitized Children in Sokoto, North Western Nigeria. J Hematol and Transfusion. 2014;2(2):1020.
Garba N, Danladi SB, Muhammad A. Determination of some haematological parameters in malaria infected subjects in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria. Bayero J Pure Applied Sci. 2015:8(1):80-3.
Al-Salahy M, Shnawa B, Abed G, Mandour A, Al-Ezzi A. Parasitaemia and Its Relation to Hematological Parameters and Liver Function among Patients Malaria in Abs, Hajjah, Northwest Yemen. Interdisciplinary Perspectives on Inf Dis. 2016:1-5.
Auta T, Runka JY, Bawa JA, Sa’adatu SK. Haemoprevalence of malaria and haematological parameters of febrile patients in a hospital in Dutsin-Ma town, North Western Nigeria. Biosciences Research in Today’s World. 2016:2:8-14.
Ani OC, Ani EG, Ogamdi SO, Okafor FC. Haematological indices of malaria infected residents of Isu community, Onicha local government area, Ebonyi state, Nigeria. Animal Res Interna. 2016;13(1):2321-7.
Ali HA, Abdulla MU, Nadeem JY, Ahmed SA, Dujana AH, Ahmed AS. Malaria and Hematological changes. Pakistan J Med Sci. 2008:24(2):287-91.
Maina RN, Walsh D, Gaddy C, Hongo G, Waitumb J, Otieno L, et al. Impact of Plasmodium falciparum infection on haematological parameters in children living in Western Kenya malaria J. 2008:9(3):1-11.
Erhart LM, Yingyuen K, Chuanak N, Buathong N, Laoboonchai A, Miller RS, Meshnick SR, Gasser Jr RA, Wongsrichanalai C. Hematologic and clinical indices of malaria in a semi-immune population of western Thailand. Am J Tropical Med Hygiene. 2004 Jan 1;70(1):8-14.
Lim SK, Ferraro B, Moore K, Halliwell B. Role of haptoglobin in free hemoglobin metabolism. Redox Report. 2001 Aug 1;6(4):219-27.
Schaer DJ, Buehler PW, Alayash AI, Belcher JD, Vercellotti GM. Hemolysis and free hemoglobin revisited: exploring hemoglobin and hemin scavengers as a novel class of therapeutic proteins. Blood, J Am Society of Hematol. 2013 Feb 21;121(8):1276-84.
Burtis CA, Ashwood ER, Bruns DE. Tietz fundamentals of clinical chemistry. Saunders, an imprint of Elsevier Inc, Philadelphia. 2008;321-322.
Huijgen HJ, Sanders GT, Koster RW, Vreeken J, Bossuyt PM. The Clinical Value of Lactate Dehydrogenase in Serum: A Quantitative Review. European J Clin Chemistry Clin Biochem. 1997 Aug 1;35(8):569-80.
Burns ER, Kale A, Murthy VV. Diagnosis of the hemolytic state using serum levels of erythrocyte adenylate kinase. Am J Hematol. 2000 Jul;64(3):180-3.
Vander JD, Hunsaker LA, Campos NM, Baack BR. D-lactate production in erythrocytes infected with Plasmodium falciparum. Molecular and Biochemical Parasitol. 1990:42:277-84.
Okocha EC, Ibeh CC, Ele PU, Ibeh NC. The Prevalence of Malaria Parasitaemia in Blood Donors in Nigeria Teaching Hospital. J Vect Borne Dis. 2005;42(1):21-6.
Monica C. Examination of Blood for Malaria Parasite. In: District Laboratory Practice in Tropical Countries Part1 Cambridge University Press 2nd ed; 2009:201-258.
McKenzie FE, Prudhomme WA, Magill AJ, Forney JR, Permpanich B, Lucas C, Gasser RA. Jr., Wongsrichanal C. White Blood Cell Counts and Malaria. J Inf Dis. 2005;192(2):323-30.
Ifeanyichukwu MO, Esan AJ. Evaluation of Blood Cells and Platelets in Plasmodium Falciparum Malaria Infected Individuals. Inter J Hematol Dis. 2014:1(1):49-54.
Kotepui M, Piwkham D, PhunPhuech B, Phiwklam N, Chupeerach C, Duangmano S. Effects of malaria parasite density on blood cell parameters. PLoS One. 2015;10(3).
Garba N, Danladi SB, Muhammad A. Determination of some haematological parameters in malaria infected subjects in Usmanu Danfodiyo University Teaching Hospital (Uduth) Sokoto, Nigeria. Bayero J Pure Applied Scien. 2015;8(1):80-3.
Gupta NK, Bansal SB, Jain UC, Sahare K. Study of thrombocytopenia in patients of malaria. Tropical Parasitol. 2013 Jan;3(1):58.
Jojera AS, Hathila RN, Patel PR, Tailor HJ. Changes in WBC and platelet count in patients with malaria: a hospital based comparative study. Int J Res Med Sci. 2013 Oct;1(4):401-3.
Kotepui M, Phunphuech B, Phiwklam N, Chupeerach C, Duangmano S. Effect of malarial infection on haematological parameters in population near Thailand-Myanmar border. Malaria J. 2014 Dec 1;13(1):218.
Dash HS, Padhy S. Study of Clinical and Laboratory Profile in Malaria. Indian J Applied Res. 2015;5(12):218-22.
Joshi G, Gamit D. Platelet profile and its correlation to paediatric patients with acute malaria in a tertiary care hospital. Sri Lanka J Child Health. 2016:45(2):107-10.
Hamid TA, Eldin FA, Elnasri HA. Effect of Malaria Parasite Infection on Platelet Parameters (Platelets count, mean platelets volume and platelets distribution width) among Malaria Patients in Khartoum State. Annals of Bio Res. 2016;7(5):18-23.
Metanat M, Sharifi-Mood B. Malaria vivax and severe thrombocytopenia in Iran. Iranian J Parasitol. 2010:69-70.
De Mast Q, De Groot PG, Van Heerde WL, Roestenberg M, Van Velzen JF, et al. Thrombocytopenia in early malaria is associated with GP1b shedding in absence of systemic platelet activation and consumptive coagulopathy. British J Haematol. 2010 Dec;151(5):495-503.
Fowkes FJ, Imrie H, Migot-Nabias F, Michon P, Justice A, Deloron P, Luty AJ, Day KP. Association of haptoglobin levels with age, parasite density, and haptoglobin genotype in a malaria-endemic area of Gabon. Am J Tropical Med Hygiene. 2006 Jan 1;74(1):26-30.
Imrie H, Fowkes FJ, Michon P, Tavul L, Hume JC, Piper KP, et al. Haptoglobin levels are associated with haptoglobin genotype and α+-thalassemia in a malaria-endemic area. The American journal of tropical medicine and hygiene. 2006 Jun 1;74(6):965-71.
Alfred B, Gwakisa P. Haptoglobin gene polymorphism influences the effect of malaria infection on host haptoglobin plasma level but not susceptibility to the disease. African J Biotechnol. 2013;12(10);1115-20.
Dabadghao V, Singh VB, Sharma D, Meena BL. Serum lactate levels in malaria and its correlation with disease severity. Intern J Adv Med Health Res. 2015;2:28-32.
Kumar TA, Keerthana BL. Serum enzyme levels as biomarkers in malaria. Scholars J Applied Medical Sciences. 2016;4:89-92.
Mtove G, Nadjm B, Hendriksen IC, Amos B, Muro F, Todd J, et al. Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital. Clin Infect Diseases. 2011 Sep 15;53(6):548-54.
Kumar IH, Kirti S, Kumar PH, Vipul S, Kumudini B. Serum total LDH activity a useful tool in aiding differential diagnosis of malaria. J Advance Res Biol Sci. 2013:5(1):25-7.
