Relationship between Serum C-reactive Protein Levels and Severity of Plasmodium falciparum Malaria in Children Seen in South-South Nigeria
Utuk Eno-Obong Edet *
Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
Ikpeme Enobong Emmanuel
Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
Udo Jacob Jackson
Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.
Okpokowuruk Frances Samuel
Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: To determine the relationship between serum C-reactive protein levels and severity of malaria infection in children aged six months to five years in a malaria endemic setting.
Study Design: A prospective cross-sectional study.
Place and Duration of Study: This study was carried out in the Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunization Centre and main Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. It was conducted over a six month period.
Methodology: We studied three hundred and sixty (360) children with microscopically confirmed Plasmodium falciparum malaria and three hundred and sixty (360) healthy controls matched for age and gender. Their serum C-reactive protein levels were measured using the highly sensitive Enzyme Linked Immunosorbent assay (ELISA). Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 17.0.
Results: The serum C-reactive protein levels showed a positive correlation with the malaria parasite count (r = 0.55; p < 0.001). Children presenting with severe manifestations of malaria had significantly higher mean serum C-reactive protein levels (33.3± 6.88mg/l) than the 8.12±9.09mg/l obtained in those with uncomplicated malaria (t = -15.57; p = 0.001.
Conclusion: This study shows that C-reactive protein levels are increased in children with malaria, especially in severe malaria. Its estimation therefore holds potential usefulness as an adjunct for assessment of malarial severity.
Keywords: Malaria, severity, C-reactive protein, children, Nigerian