Characterization of Peripheral Blood Leucocyte Subsets In Acute Plasmodium Falciparum and P. Vivax Malaria Infections at Wonji Sugar Estate, Ethiopia
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Date
2003-06
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Addis Ababa University
Abstract
The aim of this study was to assess the absolute counts and percentages of lymphocyte
and granulocyte subsets and monocytes in acute P. falciparum (pf) and P. vivax (pv)
infections. Effect of HIV infection on haematological and Parasitological values was
also assessed. Three-colour flow cytometry was used for enumerating the immune
cells. Coulter Counter was used to determine haematological values. Parasite species
were detected using light microscopy. HIV testing was done using Determine, ELISA
and Western blot. Data was analysed using STATA and SPSS softwares. 166 acute
malaria patients of whom 82 (49.4%) were infected with pf, 81 (48.8%) infected with
pv, and 3 (1.8%) infected with both pf and pv were included in the study. 8 (4.8%) (3
pf and 5 pv patients) were HIV positives. As a control, 87 age-matched subjects (46
HIV negatives and 41 HIV positives) were included. Trophozoite density was
increased in HIV positive falciparum patients than in the negatives (P=0.031).
Moreover, although statistically insignificant, sexual and asexual parasitemia was
higher in HIV positive pv patients than in the negatives. Haemoglobin (hgb),
haematocrit (hct) and platelet (plt) levels were lower in pf and pv malaria patients
(P<0.0001) than in controls. Plt level was lower in HIV positive falciparum patients
than in the negatives (P=0.049). A decrease in hct and hgb levels in both pf and pv
patients was also observed in the HIV infected. WBC count in pf patients was lower
than in controls (P=0.015). Compared to healthy controls, significant decrease in the
absolute counts of CD4+, CD8+, B, CD3+ and total lymphocytes was found in pf
(P<0.0001) and pv (P<0.0001) malaria patients. However, NK cell count was not
affected by pf or pv malaria parasite infections. No difference was found in CD4%,
CD8% and CD3% in either pf or pv, whereas B and total lymphocyte percentages
were lower in both pv (P=0.002 and P<0.0001 respectively) and pf (P=0.008 and
P<0.0001 respectively) malaria patients. Monocyte (P=0.007) and neutrophil
(P=0.035) counts were significantly increased only during pv infection. On the other
hand, eosinophil and basophil counts were decrease in pf (P<0.05) but not during pv
malaria. There was a negative correlation of CD4+, NK, CD3+, total lymphocytes
and monocyte count with the asexual stage parasite densities of pf (P<0.05), while
neutrophil counts in pf and pv malaria were positively correlated (P<0.05).
Comparing the two malaria groups, CD4+, CD8+, CD3+, total lymphocytes,
monocyte and basophil counts were lower in pf than in pv only in the rainy season
(P<0.05). This study strongly suggests the need for special considerations when
dealing with malaria patients. This includes: a) enumeration of immune cells for
diagnostic or research purposes; b) studies done on peripheral blood to evaluate
immune status of patients c) the effect of HIV on malaria parasitemia and
haematological values.
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Biology