DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20205853

Study of serum cortisol levels in complicated and uncomplicated Plasmodium vivax malaria patients

Sandeep B. R., M. G. Bhutto, Suresh Babu K. P.

Abstract


Background: Malaria results in pathological changes in various body organs, as the parasite invade and multiply in circulating red blood cells. Despite of advances in diagnostic and treatment modalities, worldwide incidences of malaria are significant. Current study was conducted to investigate serum cortisol level changes as a promising biomarker for risk prediction in malaria and to study adrenal insufficiency in malaria patients.

Methods: Current investigation was a prospective observational study, conducted on complicated and uncomplicated Plasmodium vivax malaria patients. Serum cortisol levels in patients were investigated through immunoassay using direct chemiluminescent technology and were statistically correlated with Plasmodium vivax malaria infection.

Results: Results of present investigation revealed that on day 1 there was significant difference in mean serum cortisol levels between the Plasmodium vivax malaria patients and control group and cortisol levels were significantly higher in complicated Plasmodium vivax malaria patients compared to uncomplicated cases on day 1 and 7. Cortisol levels were observed to be normal on day 1 and 7 in uncomplicated malaria cases and in patients with bleeding manifestations, renal failure and jaundice. In 10 out of 15 cases of cerebral malaria, significant increase in serum cortisol levels were observed on day 1, while on day 7 levels were normal in all 15 cases.

Conclusions: Rise in serum cortisol level had a positive correlation with temperature and thus can be useful to predict the severity of disease in Plasmodium vivax malaria patients. No cortisol insufficiency was observed in during active and convalescent stages of illness.


Keywords


Malaria, Parasitic infection, Plasmodium vivax, Plasmodium falciparum, Serum cortisol

Full Text:

PDF

References


Suh KN, Kain KC, Keystone JS. Malaria. Can Med Assoc J. 2004;170(11):1693-702.

Talapko J, Škrlec I, Alebić T, Jukić M, Včev A. Malaria: the past and the present. Microorganisms. 2019;7(6):179.

World Malaria Report 2018 by WHO. Available at: https://www.who.int/malaria/publications/world-malaria-report-2018/en/. Accessed on 15 September 2020.

Das A, Anvikar AR, Cator LJ, Dhiman RC, Eapen A, Mishra N, et al. Malaria in India: the center for the study of complex malaria in India. Acta Trop. 2012;121(3):267-73.

Anvikar AR, Shah N, Dhariwal AC, Singh JS. Epidemiology of Plasmodium vivax Malaria in India. Am J Trop Med Hyg. 2016;95(6 Suppl):108-20.

White NJ, Pukrittayakamee S, Hien TT, Faiz MA, Mokuolu OA, Dondorp AM. Malaria. Lancet. 2014;383(9918):723-35.

Siciliano G, Alano P. Enlightening the malaria parasite life cycle: bioluminescent Plasmodium in fundamental and applied research. Front Microbiol. 2015;6:391.

Aly AS, Vaughan AM, Kappe SH. Malaria parasite development in the mosquito and infection of the mammalian host. Annu Rev Microbiol. 2009;63:195-221.

Adini A, Krugliak M, Ginsburg H, Li L, Lavie L, Warburg A. Transglutaminase in Plasmodium parasites: activity and putative role in oocysts and blood stages. Mol Biochem Parasitol. 2001;117:161-8.

Meibalan E, Marti M. Biology of malaria transmission. Cold Spring Harb Perspect Med. 2017;7(3):a025452.

White NJ. The treatment of malaria. N Engl J Med. 1996 Sep 12;335(11):800-6.

Akinosoglou KA, Pasvo G. The management of malaria in adults. Clin Med (Lond). 2011;11(5):497-501.

Castelli F, Tomasoni LR, Matteelli A. Advances in the treatment of malaria. Mediterr J Hematol Infect Dis. 2012;4(1):e2012064.

Griffith KS, Lewis LS, Mali S, Parise ME. Treatment of malaria in the United States: a systematic review. JAMA. 2007;297:2264-70.

Mukry SN, Saud M, Sufaida G, Shaikh K, Naz A, Shamsi TS. Laboratory diagnosis of malaria: comparison of manual and automated diagnostic tests. Can J Infect Dis Med Microbiol. 2017;2017:9286392.

Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S. Malaria diagnosis: a brief review. Korean J Parasitol. 2009;47(2):93-102.

Kasetsirikul S, Buranapong J, Srituravanich W, Kaewthamasorn M, Pimpin A. The development of malaria diagnostic techniques: a review of the approaches with focus on dielectrophoretic and magnetophoretic methods. Malar J. 2016;15(1):358.

Murray CK, Gasser RA, Magill AJ, Miller RS. Update on rapid diagnostic testing for malaria. Clinical Microbiology Reviews. 2008;21(1):97-110.

Fukuda S, Morimoto K. Lifestyle, stress and cortisol response: Review II : lifestyle. Environ Health Prev Med. 2001;6(1):15-21.

Lee DY, Kim E, Choi MH. Technical and clinical aspects of cortisol as a biochemical marker of chronic stress. BMB Rep. 2015;48(4):209-16.

Oswald LM, Zandi P, Nestadt G, Potash JB, Kalaydjian AE, Wand GS. Relationship between cortisol response to stress and personality. Neuropsychopharmacology. 2006;31:1583-91.

Qin DD, Rizak J, Feng XL. Prolonged secretion of cortisol as a possible mechanism underlying stress and depressive behaviour. Sci Rep. 2016;6:30187.

Davis TM, Li TA, Tran QB, Robertson K, Dyer JR, Phan TD, Meyer D, Beaman MH, Trinh KA. The hypothalamic-pituitary-adrenocortical axis in severe falciparum malaria: effects of cytokines. J Clin Endocrinol Metab. 1997 Sep;82(9):3029-33.

Sharma RK, Thakor HG, Saha KB, Sonal GS, Dhariwal AC, Singh N. Malaria situation in India with special reference to tribal areas. Indian J Med Res. 2015;141(5):537-45.

Kumar A, Valecha N, Jain T, Dash AP. Burden of malaria in India: retrospective and prospective view. Am J Trop Med Hyg. 2007;77(6 Suppl):69-78.

Wilson M, Davis TM, Binh TQ, Long TT, Danh PT, Robertson K. Pituitary-adrenal function in uncomplicated falciparum malaria. Southeast Asian J Trop Med Public Health. 2001;32(4):689-95.

Shwe T, Khin M, Min H, Hla KK, Win YY, Htwe K, Thu TM. Serum cortisol levels in patients with uncomplicated and cerebral malaria. Southeast Asian J Trop Med Public Health. 1998;29(1):46-9.

Libonati RM, de Mendonça BB, Maués JA, Quaresma JA, de Souza JM. Some aspects of the behavior of the hypothalamus-pituitary-adrenal axis in patients with uncomplicated Plasmodium falciparum malaria: Cortisol and dehydroepiandrosterone levels. Acta Trop. 2006;98(3):270-6.

Ibrahim EA, Kheir MM, Elhardello OA, Almahi WA, Ali NI, Elbashir MI, Ishag A. Cortisol and uncomplicated Plasmodium falciparum malaria in an area of unstable malaria transmission in eastern Sudan. Asian Pac J Trop Med. 2011;4(2):146-7.