Haematological parameters and plasma levels of 8-iso-prostaglandin F2α in malaria-sickle cell co-morbidity: A cross sectional study

Abstract

Malaria and sickle cell disease (SCD) co-morbidity have previously been reported in Ghana. However, there is paucity of data on haematological profiles and oxidative stress in comorbidity states. This study identified novel inflammatory biomarkers associated with malaria in SCD and analyzed the levels of 8-iso-prostaglandin F2α oxidative stress biomarker in malaria SCD co-morbidity in Ghanaian patients. Methods Blood (5ml) was collected from malaria patients into K3-EDTA tube. Malaria parasites speciation and quantification were then done according WHO guidelines. All eligible samples were assayed for haematological profile, sickle cell phenotyping, infectious markers (hepatitis B, hepatitis C, syphilis and HIV 1&2) and plasma levels of 8-epi-prostaglandin F2α. .Results Prevalence of malaria in SCD (malaria-SCD) was 13.4% (45/335). Male: female ratio was 0.8:1 (X2=1.43, p=0.231). Mean ages for malaria in normal haemoglobin type (malaria-HbAA) and malaria-SCD were 12.79±4.91 and 11.56±3.65 years respectively (p=0.048). Geometric mean of parasite density was higher in malaria-HbAA (20394 parasites/µl vs. 9990 parasites/µl, p=0.001) whilst mean body temperature was higher in malaria-SCD (39.0±0.87°C vs. 37.9±1.15°C, 41 p=0.001). Mean leukocytes, lymphocytes, eosinophils, monocytes, platelets and platelet indices values were significantly elevated in malaria-SCD. Significant reduction in RBC and RBC indices in malaria-SCD were also observed. Eosinophils-to-basophils ratio (EBR) and monocytes-to basophils ratio (MBR) were novel cellular inflammatory biomarkers which could predict malaria in SCD. The sensitivities of cut-off values of EBR>14, MBR>22 and combined use of EBR>14 and MBR>22 were 79.55%, 84.09% and 91.11% respectively. Mean 8-iso-prostaglandin F2α was 338.1pg/ml in malaria-HbAA and 643.8pg/ml in malaria-SCD (p=0.001). 8-iso-prostaglandin F2α correlated with parasite density (r=0.787, p=0.001), temperature (r=0.566, p=0.001) and leucocytes (r=0.573, p=0.001) and negatively correlated with RBC (r=-0.476, p=0.003), haemoglobin (r=-0.851, p=0.001) and haematocrit (r=-0.735, p=0.001).Conclusion Plasmodium falciparum parasitaemia increases oxidative damage and causes derangement haematological parameters. Cut of values of EBR>14 and MBR>22 could predict malaria in SCD