Abstract:
Blood (5ml) was collected from suspected malaria patients (n=2272)
into K3-EDTA tube. Samples were grouped as malaria infections in
normal haemoglobin (malaria-HbAA), malaria infections in sickle cell
disease (malaria-SCD), malaria infections in sickle cell trait (malaria-
SCT) and non-malaria with normal haemoglobin (controls). The aim of
the study was to evaluate the effect of Plasmodium falciparum infections
on haematological, biochemical profiles and oxidative stress in sickle
cell patients as paucity of data exist in this regard. Malaria parasites
were identified and quantified according to WHO guidelines. All eligible
samples were assayed for haematological and biochemical parameters,
T-cell profiling and levels of 8-iso-prostaglandin F2α oxidative stress
biomarker. The study found that geometric mean of parasite density was
higher in malaria-HbAA than malaria-SCD (20394 parasites/µl vs. 9990
parasites/µl, p=0.001) whilst mean body temperature was higher in
malaria-SCD and malaria-HbAA than control samples and malaria-SCT.
Mean leukocytes were significantly elevated in co-morbidity states while
lymphopenia and neutrophilia were associated with malaria-HbAA and
malaria-SCD. However, CD3+, CD4+ and CD8+ T cells were significantly
higher in malaria-HbAA than malaria-SCD. Eosinophilia was also
associated with malaria-SCT while monocytosis was seen in malaria-
SCD. Severely low red blood cells, low haemoglobin concentrations
and low red cell indices were seen in malaria-SCD with corresponding
significant elevations in plasma haemoglobin, % haemolysis, serum
potassium, serum bilirubin and lactate dehydrogenase in malaria-
SCD. Levels of means 8-iso-prostaglandin F2α in all the patient groups
were significantly higher than the control sample with compounding
levels seen in malaria-SCD group. In conclusion, severe haemolysis
was observed in malaria-SCD co-morbidity which associated with
compounding oxidative stress. Exhaustive clinical assessment must be
done to prevent or reduce oxidant related pathologies in SCD patients
