Serum C-Reactive Protein and Cholesterol as Predictors of Severity in Childhood Falciparum Malaria Infestation Among Nigerians

Abstract

Background: C-Reactive-Protein (CRP) is regarded as one of the most sensitive indicators of acute inflammation and its concentration often increases or decreases by about 2%. Although CRP is a nonspecific marker of inflammation, very high CRP levels are observed during attacks of malaria. CRP is a good positive predictive indicator for the diagnosis of malaria and is also useful in epidemiological studies on malaria. Depletion of red cell cholesterol has no detectable effect on major red cell membrane function but can block malaria invasion. Malaria parasite count on peripheral blood film has been reported not to be indicative of an acute infestation, thus highlighting the need for an alternative indicator of acute malarial infestation. Materials and Methods: A total of 120 paediatric subjects were randomly recruited for the study from among those diagnosed routinely in the Haematology Laboratory of University of Ilorin Teaching Hospital of acute malaria. They were grouped into those with mild, moderate and severe malaria with 40 persons in each group. Their samples were further subjected to tests for malaria density, CRP and cholesterol levels determination. Results: The mean ages of our subjects with mild, moderate and severe malaria were 10.3±1.5 years, 7.1±2.2 years and 3.8±1.3 years respectively. Serum CRP levels significantly increases while that of cholesterol significantly reduces with increase in parasite scoring and absolute count (p values <0.005). Also the levels of serum CRP correlated positively while that of cholesterol correlated negatively with parasite scoring and count. Conclusion: In conclusion, serum C-reactive protein can be said to be a good indicator of the severity of malaria in our environment although it is not routinely done. Cholesterol level which correlated negatively with parasite density, can also serve as an indicator of severity of falciparum malaria infestation.