Study of C-Reactive Protien as a Prognostic Marker in Malaria
Study of C-Reactive Protien as a Prognostic Marker in Malaria
DOI:
https://doi.org/10.70284/njirm.v6i1.855Keywords:
malaria,C-reactive protein, mortalityAbstract
Background: India is a hyper-endemic zone for malaria. We need tests which can be done easily and are cost effective to assess the severity of the disease and to help in prognostication. CRP is one such investigation which can be used. Aims And Objectives: We carried out this prospective study to find the correlation between the level of CRP and the complications in patients of P.vivax and P. falciparum malaria. Material and Methods: Level of C- reactive protein, was measured in 227 patients of P.vivax and P. falciparum malaria, admitted in GMERS medical college Gotri, Vadodara. It was then compared with single and multiple complications as well as with the duration of hospital stay in both vivax and falciparum patients.Statistical analysis was done using Chi-Square test, unpaired T-test and ROC curve. Results: Out of 227 patients,105(46.2%) had P.vivax and 122(53.7%) had P. falciparum malaria. CRP level was high in all patients. In vivax and falciparum patients with single complications, the mean CRP level was 24+11.6 mg/L and 24.1+6.2 mg/L respectively. Both types of malaria with multiple complications showed very high levels, 69.6 + 14.1mg/L in P.Falciparum and 71.6 + 6.5mg/L in P.vivax patients. Elevated CRP level (41.5 mg/L) also predicted a prolonged hospital stay. Conclusion: Our study corroborates the observation that high CRP level has a strong prognostic value for predicting the complications in malaria. [Surname + name char.NJIRM 2015; 6(1):52-56]
References
2. Erdman L K, Dhabangi A, Musoke C et al. Combinations of host biomarkers predict mortality among Ugandan children with severe malaria: a retrospective case-control study.PLoS One.2011 Feb 25;6(2):e17440.doi:10.1371/journal.pone.0017440
3. Rudrajit Paul,Pradip Sinha, Jayanti Mondal et al. Study of C reactive protein as a prognostic marker in malaria from Estern India. Advanced Biomedical Research.2012;1:41.
4. Vandana Agrawal,Vaishali Jain, Shubho Biswas. IOSR Journal of Dental and Medical Sciences(IOSR-JDMS) Vol.8,issue 2(Jul-Aug. 2013)
5. P.Naik and A.Voller. Serum C-reactive protein levels and falciparum malaria.Transactions of the Royal Society of Tropical Medicine and Hygiene.1983; volume 78,Issue 6,p 812-813.
6. N.Hurt, T Smith,LTeusher and M Tanner. Clinical and Vaccine Immunology.July 1994; vol. 1 no. 4,437-444.
7. Ansar W, Habib SK, Roy S, Mandal C, Mandal C: Unraveling the C-reactive protein complement-cascade in destruction of red blood cells: potential pathological implications in Plasmodium falciparum malaria. Cell Physiol Biochem 2009, 23:175-190.
Malaguarnera L, Musumeci S: The immune response to Plasmodium falciparummalaria.
Lancet Infect Dis 2002, 2:472-478
9. Abrams ET, Kwiek JJ, V M, Kamwendo DD, Tadesse E, V L, Molyneux ME, Rogerson SJ, Meshnick SR: Malaria during pregnancy and foetal haematological status in Blantyre, Malawi. Malar J 2005, 4:39
10. Wilczynski JR, Radwan M, Kalinka J: The characterization and role of regulatory T cells in immune reactions. Front Biosci 2008, 13:2266-2274
11. Walther M, Tongren JE, Andrews L, Korbel D, King E, Fletcher H, Andersen RF, Bejon P, Thompson F, Dunachie SJ, Edele F, de Souza JB, Sinden RE, Gilbert SC, Riley EM, Hill AV:Upregulation of TGF-beta, FOXP3, and CD4+CD25+ regulatory T cells correlates with more rapid parasite growth in human malaria infection. Immunity 2005, 23:287-296.
12. Zhang R, Becnel L, Li M, Chen C, Yao Q: C-reactive protein impairs human CD14+ monocyte-derived dendritic cell differentiation, maturation and function. Eur J Immunol 2006, 36:2993-3006.
13. Zhong W, Zen Q, Tebo J, Schlottmann K, Coggeshall M, Mortensen RF: Effect of human C-reactive protein on chemokine and chemotactic factor-induced neutrophil chemotaxis and signaling.J Immunol 1998, 161:2533-2540.
14. Brown J, Smalley ME: Inhibition of the in vitro growth of Plasmodium falciparum by human polymorphonuclear neutrophil leucocytes.Clin Exp Immunol 1981, 46:106-109.
15. Pierrot C, Adam E, Hot D, Lafitte S, Capron M, George JD, Khalife J: Contribution of T cells and neutrophils in protection of young susceptible rats from fatal experimental malaria. J Immunol 2007, 178:1713-1722.
16. Fikregabrail Aberra Kassa,Marina Tiemi Shio,Marie-Josée Bellemare,Babacar Faye,Momar Ndao,Martin Olivier : New Inflammation-Related Biomarkers during Malaria Infection ,journal.plosone. , 2011, Volume 6, Issue 10:e26495
