SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Laboratory markers of disease severity in Plasmodium knowlesi infection: a case control study.

Willmann, M; Ahmed, A; Siner, A; Wong, IT; Woon, LC; Singh, B; Krishna, S; Cox-Singh, J (2012) Laboratory markers of disease severity in Plasmodium knowlesi infection: a case control study. Malar J, 11. p. 363. ISSN 1475-2875 https://doi.org/10.1186/1475-2875-11-363
SGUL Authors: Krishna, Sanjeev

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution.

Download (534kB) | Preview

Abstract

BACKGROUND: Plasmodium knowlesi malaria causes severe disease in up to 10% of cases in Malaysian Borneo and has a mortality rate of 1 - 2%. However, laboratory markers with the ability to identify patients at risk of developing complications have not yet been assessed as they have for other species of Plasmodium. METHODS: A case control study was undertaken in two hospitals in Sarikei and Sibu, Malaysian Borneo. One hundred and ten patients with uncomplicated (n = 93) and severe (n = 17) P. knowlesi malaria were studied. Standardized pigment-containing neutrophil (PCN) count, parasite density and platelet counts were determined and analysed by logistic regression and receiver operating characteristic (ROC) analysis. RESULTS: The PCN count was strongly associated with risk of disease severity. Patients with high parasite density (≥ 35,000/μl) or with thrombocytopaenia (≤ 45,000/μl) were also more likely to develop complications (odds ratio (OR) = 9.93 and OR = 5.27, respectively). The PCN count yielded the highest area under the ROC curve (AUC) estimate among all markers of severity (AUC = 0.8561, 95% confidence interval: 0.7328, 0.9794). However, the difference between all parameter AUC estimates was not statistically significant (Wald test, p = 0.73). CONCLUSION: Counting PCN is labour-intensive and not superior in predicting severity over parasitaemia and platelet counts. Parasite and platelet counts are simpler tests with an acceptable degree of precision. Any adult patient diagnosed with P. knowlesi malaria and having a parasite count ≥ 35,000/μl or ≥ 1% or a platelet count ≤ 45,000/μl can be regarded at risk of developing complications and should be managed according to current WHO guidelines for the treatment of severe malaria.

Item Type: Article
Additional Information: © Willmann et al.; licensee BioMed Central Ltd. 2012 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Adult, Biomarkers, Borneo, Case-Control Studies, Female, Hemeproteins, Humans, Leukocyte Count, Malaria, Male, Middle Aged, Models, Biological, Neutrophils, Parasite Load, Parasitemia, Pigments, Biological, Plasmodium knowlesi, Platelet Count, Severity of Illness Index, Neutrophils, Humans, Plasmodium knowlesi, Parasitemia, Malaria, Hemeproteins, Biological Markers, Leukocyte Count, Platelet Count, Severity of Illness Index, Case-Control Studies, Models, Biological, Adult, Middle Aged, Borneo, Female, Male, Pigments, Biological, Parasite Load, Plasmodium knowlesi, Severity markers, Malaria pigment, Parasitaemia, Platelet count, Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, Parasitology, Tropical Medicine, PARASITOLOGY, TROPICAL MEDICINE, Plasmodium knowlesi, Severity markers, Malaria pigment, Parasitaemia, Platelet count, CONTAINING LEUKOCYTES, MALARIA PIGMENT, CHILDREN, ASSOCIATION, HAEMOZOIN, THAILAND, Tropical Medicine, 1108 Medical Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Malar J
ISSN: 1475-2875
Language: eng
Dates:
DateEvent
30 October 2012Published
18 October 2012Accepted
Publisher License: Creative Commons: Attribution 2.0
Projects:
Project IDFunderFunder ID
G0801971Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 23110615
Web of Science ID: WOS:000313239700001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109785
Publisher's version: https://doi.org/10.1186/1475-2875-11-363

Actions (login required)

Edit Item Edit Item