Plasmodium falciparum Biomass and Haematological Changes during Treatment of HIV/AIDS Patients in Western Kenya

Main Article Content

J. K. Kirinyet
C. S. Mulambalah

Abstract

Background: Monitoring and evaluation (M & E) of anti-malarial treatment among people living with HIV/AIDS (PLWHA) is very important to assess the response and change in malaria parasite biomass in an endemic area. Published data have shown that HIV-related immunosuppression correlates with increased malaria biomass, treatment failure and complicated outcome despite an individual's immune status. We evaluated blood samples from PLWHA based on malaria parasite biomass and haematological changes during anti-malarial treatment

Aim: To evaluate Plasmodium falciparum biomass and haematological changes during antimalarial treatment of PLWHA.

Settings and Designs: Cross-sectional and descriptive study design

Subjects and Methods: A randomized antimalarial treatment involving 126 subjects was carried out in a hospital setup in Western Kenya. Blood samples were collected and analysed to determine malaria parasitaemia, changes in parasite biomass and haemoglobin levels in 28 days among PLWHA following treatment with Quinine and Coartem® antimalarial drugs.  Descriptive and chi-square tests were used to determine the association of parasitaemia with gender and relevant haematological changes during treatment.

Results: A significant difference between females and males of those with parasitaemia on day-3 was noticed (p - 0.031). Quinine and Coartem® arms recorded a 100% parasite deletion/clearance by day-14 but showed recurrence on day-21 of 6.3% and 3.1% of day-14 respectively. On day-28 the Quinine arm had higher parasitaemia (306.3%).   Mean Hb improved from 11.0 gm/dL to 11.6 gm/dL by day-28.

Conclusion: Recurrence of malaria parasite biomass was noticeable from day-21 to day-28 with Quinine arm of recipients and by day-28 haematological parameters had improved indicating recovery.   Routine M &E of malaria cases and haematinic agent dosages to correct anaemia among PLWHA are recommended.

Keywords:
Plasmodium falciparum, haematological changes, anti-malaria, WHO

Article Details

How to Cite
Kirinyet, J. K., & Mulambalah, C. S. (2021). Plasmodium falciparum Biomass and Haematological Changes during Treatment of HIV/AIDS Patients in Western Kenya. International Journal of TROPICAL DISEASE & Health, 42(3), 1-11. https://doi.org/10.9734/ijtdh/2021/v42i330440
Section
Original Research Article

References

W.H.O. Malaria in HIV/AIDS patients; 2017. Last update: 27 April 2017 W.H.O. Antimalarial drug efficacy and drug resistance; 2018. (update: 27 April 2018).

Dinko B, Pradel G. Immune evasion by Plasmodium falciparum parasites: converting a host protection mechanism for the parasite’s benefit. Advances in Infectious Diseases. 2016;6(2):67759. View at: Publisher Site | Google Scholar

Khoury DS, Cromer D, Best SE, James KR, Kim PS, Engwerda CR, et al. Effect of mature blood-stage Plasmodium Parasite sequestration on pathogen biomass in mathematical and In vivo models of malaria. Infection and Immunity. 2014; 82:212–220.

Barber BE, Grigg MJ, William T, Piera KA, Boyle MJ, Yeo TW, et al. Effects of aging on parasite biomass, inflammation, endothelial activation, microvascular dysfunction and disease severity in Plasmodium knowlesi and Plasmodium falciparum Malaria. The Journal of Infectious Diseases. 2017;215:1908–1917.

Kingston HW, Ghose A, Plewes K, Ishioka H, Leopold SJ, Maude RJ, et al. Disease severity and effective parasite multiplication rate in Falciparum malaria. Infectious diseases society of America; 2017. http://creativecommons.org/licenses/by/4.0/. DOI: 10.1093/ofid/ofx169.

Cunnington JA, Bretscher MT, Nogaro SI, Riley ME, Walther M. Comparison of parasite sequestration in uncomplicated malaria and severe childhood Pf malaria. The British Infection Association; 2013. http://dx.doi.org/10.1016/j.jinf.2013.04.013.

Bernabeu M, Danziger SA, Avrila M, Vazb M, Babar PH, Braziera AJ, et al. Severe adult malaria is associated with specific PfEMP1 adhesion types and high parasite biomass. Freely available online through the PNAS open access option; 2016.

accession nos. KU843600–KU843604). Email: joe.smith@cidresearch.org. This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10. 1073/pnas.1524294113/-/DCSupplemental.

Van geertruyden. Interactions between malaria and human immunodeficiency virus anno. Clin Microbiol Infect. 2014; 20:278–285.

Van geertruyden JP, Menten J, Colebunders R, Korenromp E, D’Alessandro U. The Impact of HIV-1 on the malaria parasite biomass in adults in sub-Saharan Africa contributes to the emergence of anti-malarial drug resistance. Malaria Journal. 2008;7:34-46.

Franke MF, Spiegelman D, Ezeamama A, Aboud S, Msamanga GI, et al. Malaria parasitemia and cd4 t cell count, viral load, and adverse HIV outcomes among HIV-infected pregnant women in Tanzania. Am. J. Trop. Med. Hyg. 2010; 82:556–562 DOI:10.4269/ajtmh.2010.09-0477.

White NJ, Pukrittayakamee S, Hien TT, Faiz MA, Mokuolu OA, Dondorp AM. Malaria. Lancet. 2014;383:723–735.

Cheng Q, Kyle DE, Gatton ML. Artemisinin resistance in plasmodium falciparum: A process linked to dormancy. International Journal for Parasitology: Drugs and Drug Resistance. 2012;2:249–255.

Dondorp AM, Nosten F, Yi P, Das D, Phyo AP, et al. Artemisinin resistance in Plasmodium falciparum malaria, N Engl J Med. 2009;361:455-467. [PMC free article] [PubMed] [Google Scholar].

Noedl H, Se Y, Schaecher K, Smith BL, Socheat D, et al. Evidence of artemisinin-resistant malaria in western Cambodia, N Engl J Med. 2008;359:2619-2620 [PubMed] [Google Scholar].

Sibley CH, Price RN. Monitoring antimalarial drug resistance: Applying lessons learned from the past in a fast-moving present. International Journal for Parasitology: Drugs and Drug Resistance. 2012;2:126–133.

W.H.O. Guidelines for the treatment of malaria. 3rd ed. Geneva: World Health Organization; 2015.

Auvert B, Buvé A, Lagarde E, Kahindo M, Chege J, et al. Male circumcision and HIV infection in four cities in sub-Saharan Africa. AIDS. 2001;15:S31–S40.

Lemeshow S, Hosmer DW, Klar J, Lwanga SK. Adequacy of sample size in health studies. Published on behalf of WHO by Wiley, Chichester. 1990;xii + 233. ISBN: 0471925179 (ISBN13: 9780471925170).

de Souze JB, Riley EM. Cerebral malaria: the contribution of studies in animal models to our understanding of immunopathogenesis. Microbes and Infection. 2002;4:291-300.

McKenzie FE, Prudhomme WA, Magill AJ, Forney JR, Permpanich B, et al. White blood cell counts and malaria. J Infect Dis. 2005;192:323-330.

Zwang J, D’Alessandro U, Ndiaye JL, Djimdé AA, Dorsey G, et al. Haemoglobin changes and risk of anaemia following treatment for uncomplicated falciparum malaria in sub-Saharan Africa. BMC Infectious Diseases. 2017;17:443-452. DOI: 10.1186/s12879-017-2530-6

Rehman K, Lo¨tsch F, Kremsner PG, Ramharter M. Haemolysis associated with the treatment of malaria with artemisinin derivatives: a systematic review of current evidence. International Journal of Infectious Diseases. 2014;29:268-273. White NJ. Anaemia and malaria. White Malar J. 2018;17:371-387.

Miller JL, Sack BK, Baldwin M, Vaughan AM, Kappe SHI. Interferon-mediated innate immune responses against malaria parasite liver stages. Cell Reports. 2014; 7:436–447.

Dodoo D, Omer FM, Todd J, Akanmori BD, Koram KA, Riley EM. Absolute levels and ratios of pro-inflammatory and anti-inflammatory cytokine production In vitro predict clinical immunity to Plasmodium falciparum malaria. The Journal of Infectious Diseases. 2002;185:971–979.

Travassos MA, Laufer MK. Resistance to antimalarial drugs: molecular, pharmacologic, and clinical considerations. Pediatr Res. 2009;65:64R–70R.