Prognostic Value of Circulating Pigmented Cells in African Children with Malaria
Open Access
- 1 January 2009
- journal article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 199 (1), 142-150
- https://doi.org/10.1086/595295
Abstract
Background.Plasmodium falciparum malaria is a common cause of morbidity in African children, but identifying those who are likely to die is problematic. Previous studies suggested that circulating malarial pigment might be a useful predictor of severity, but none were large enough to detect any association with mortality. Methods. We used thick blood smears performed on admission for 26,296 children hospitalized with P. falciparum at 1 of 6 hospitals in the Severe Malaria in African Children network to assess the prognostic value of pigment-containing granulocytes, monocytes, and parasites. Results. Although at all but one of the study sites the risk of mortality for subjects presenting with >5 pigmented granulocytes per 200 white blood cells was higher than in subjects with no pigmented granulocytes, adjusted odds ratios estimated through logistic regression, which included other established markers of severe malaria, suggested that associations between pigmented cells and mortality were moderate to nonexistent in most sites. The predictive ability of pigmented cells was low, as measured by the change in the area under the receiver operating characteristic curve of logistic regression models. Conclusions. Although high levels of pigmented cells were associated with a fatal outcome in some study sites, they were not useful predictors of outcome across Africa.Keywords
This publication has 20 references indexed in Scilit:
- Suppression of erythropoiesis in malarial anemia is associated with hemozoin in vitro and in vivoBlood, 2006
- Suppression of Prostaglandin E2by Malaria Parasite Products and Antipyretics Promotes Overproduction of Tumor Necrosis Factor–α: Association with the Pathogenesis of Childhood Malarial AnemiaThe Journal of Infectious Diseases, 2006
- The Prognostic Value of Measures of Acid/Base Balance in Pediatric Falciparum Malaria, Compared with Other Clinical and Laboratory ParametersClinical Infectious Diseases, 2005
- Sensitivity of hemozoin detection by automated flow cytometry in non- and semi-immune malaria patientsCytometry Part B: Clinical Cytometry, 2003
- A Physiochemical Mechanism of Hemozoin (β-Hematin) Synthesis by Malaria ParasiteBiochemical and Biophysical Research Communications, 2002
- Low Interleukin-12 Activity in SeverePlasmodium falciparumMalariaInfection and Immunity, 2000
- Intraleucocytic malaria pigment and clinical severity of malaria in childrenTransactions of the Royal Society of Tropical Medicine and Hygiene, 1998
- Malaria pigment in leucocytesTransactions of the Royal Society of Tropical Medicine and Hygiene, 1995
- Intraleucocytic malaria pigment and prognosis in severe malariaTransactions of the Royal Society of Tropical Medicine and Hygiene, 1995
- Impairment of macrophage functions after ingestion of Plasmodium falciparum-infected erythrocytes or isolated malarial pigment.The Journal of Experimental Medicine, 1992