Abstract:
Introduction
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 co-
morbidity 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
or 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,
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
2bioRxiv preprint doi: https://doi.org/10.1101/441998; this version posted October 12, 2018. The copyright holder for this preprint (which was not
certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under
aCC-BY 4.0 International license.
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.
