Serum Ferritin and Asymptomatic Malaria: A study in Calabar, Nigeria.

Abstract

Introduction

Ferritin is a blood cell protein that contains iron. The serum ferritin level is widely accepted as an accurate indicator of body iron store being the only factor that can give a semi-quantitative indication of the levels of Iron storage. Increased serum ferritin has been reported in asymptomatic malaria infection.This study was done to determine the serum ferritin levels in asymptomatic malaria individuals in Calabar, Cross River State, Nigeria. Ninety (90) apparently healthy subjects were recruited, both male and female within the age of 18 to 65 years.

Materials and Method

 The serum ferritin level was assayed using ELISA quantitative method. The Hb and PCV were also assayed using the automated cellular counter Sysmex Kx-21N. Malaria parasite detection was through examination of peripheral blood smears using 2% Giemsa.

Results

The mean serum ferritin levels for the malaria infected subjects was (25.11±1.27ng/ml), and this was significantly higher than the uninfected subjects (16.81±4.66ng/ml) (P<0.05). Mean serum ferritin level for infected males was (20.95±8.79ng/ml) which is slightly higher than uninfected males (16.01±3.53ng/ml) (P>0.05).  The results also show mean serum ferritin for infected females to be (30.57±3.42ng/ml) which is higher than the uninfected females (18.65±1.98ng/ml). This result likewise shows significantly low level of Hb(12.97±1.5g/dl) and PCV (0.38±2.18L/L) in apparently healthy malaria infected individuals while high level of Hb(15.20±1.73g/dl) and PCV (0.44±1.58L/L) were observed among the uninfected subjects. There was also significant difference seen in infected male and infected  female subjects, likewise the aparasitaemic males and females had significant difference (P<0.05).

Conclusion

 This study has shown that asymptomatic malaria parasitaemia increases serum ferritin level, hence serum ferritin estimation without examination for malaria parasitaemia in malaria endemic area such as Calabar, Nigeria may not be reliable. The study also shows that asymptomatic malaria parasitaemia constitutes a significant disease burden and a challenge that should be of global health concern.