Plasmodium Parasitemia and Its Relationship With Hematological, Liver, and Kidney Function of Patients With Falciparum Malaria in the Eastern Region, Ghana

加纳东部地区恶性疟患者的疟原虫血症及其与血液、肝脏和肾脏功能的关系

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Abstract

BACKGROUND: Malaria remains a significant public health challenge in Sub-Saharan Africa, including Ghana. Children and adults present with varying clinical and biochemical pictures in response to Plasmodium infection. Thus, the study aimed to explore the relationship between Plasmodium parasitemia and hematological, liver, and kidney function of children and adult participants, highlighting possible variations. METHOD: The cross-sectional study was conducted in a public and a private health facility in the Eastern Region of Ghana from August 2023 to September 2023. Participants of the study comprised children under 5 years and adults 18 years and above. Structured questionnaires were used to gather participants' demographic information and medical history. Blood samples of participants were analyzed with standard microscopy technique for Plasmodium parasites. Hematological and biochemical parameters were also measured with fully automated hematology and chemistry analyzers, respectively. Data were analyzed using IBM SPSS Version 22. χ (2) analysis was performed to determine if differences in the degree of Plasmodium parasitemia and some demographic characteristics were significant. Kruskal-Wallis and post-hoc pairwise tests were used to determine differences in hematological and biochemical parameters across categories of Plasmodium parasitemia. Statistical significance was assumed at a p value < 0.05. RESULTS: The study enrolled 362 participants, comprising of 71.8% (260/362) adults and 69.3% (251/362) females. No significant differences were observed among gender and age categories across parasitemia levels, although a higher proportion of children < 5 years (51.9%, 53/102) recorded high parasitemia. Adult participants with high parasitemia recorded significantly lower Hb, RBC, MCV, MCH and PLT but higher ALT and AST than those with lower and moderate parasitemia. However, there was no significant variations in urea and creatinine levels with regard to degree of parasitemia among the participants. CONCLUSION: High Plasmodium parasitemia was linked with significant hematological and hepatic alterations, with distinct variations between adults and children < 5. The alterations observed in patients with high parasitemia highlight the importance of frequent and routine monitoring of these patients to address potential dysfunction early to prevent severe complications.

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