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Markers of inflammation in children with severe malarial anaemia

  1. Godfrey Biemba1,2,
  2. Victor R. Gordeuk3,
  3. Philip Thuma4,
  4. Günter Weiss5

Article first published online: 25 DEC 2001

DOI: 10.1046/j.1365-3156.2000.00545.x

Issue

Tropical Medicine & International Health

Tropical Medicine & International Health

Volume 5, Issue 4, pages 256–262, April 2000

Additional Information

How to Cite

Biemba, G., Gordeuk, V. R., Thuma, P. and Weiss, G. (2000), Markers of inflammation in children with severe malarial anaemia. Tropical Medicine & International Health, 5: 256–262. doi: 10.1046/j.1365-3156.2000.00545.x

Author Information

  1. 1

    Churches Medical Association of Zambia, Lusaka, Zambia

  2. 2

    Macha Mission Hospital, Choma, Zambia

  3. 3

    Department of Medicine, Howard University, Center, Washington DC, USA

  4. 4

    Department of Natural Sciences, Messiah College, Grantham, USA

  5. 5

    Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria

*correspondence Victor R. Gordeuk MD, Department of Medicine and Center for Sickle Cell Disease, Howard University, 2121 Georgia Ave. NW, Washington, DC 20059, USA. E-mail: vgordeuk@howard.edu

Publication History

  1. Issue published online: 25 DEC 2001
  2. Article first published online: 25 DEC 2001

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Keywords:

  • malaria;
  • anaemia;
  • neopterin;
  • interleukin 4;
  • interleukin 10;
  • Zambia

Summary OBJECTIVE   To investigate if severe malarial anaemia is associated with a specific immune response pattern, we determined serum levels of neopterin (a marker of activation of macrophages by interferon-γ) and of the anti-inflammatory cytokines, interleukins 4 and 10.

METHODS   Zambian children < 6 years of age presenting to a rural hospital with cerebral malaria were studied. Twenty-one children with admission haemoglobin concentrations ≤ 5 g/dl were classified as having severe anaemia and 40 with haemoglobin concentrations ≥ 7 g/dl served as a control group.

RESULTS   Logistic regression modelling indicated that a 10-fold rise in serum neopterin concentrations was associated with a 50-fold increase in the estimated odds of having severe anaemia (P = 0.015), while a 10-fold rise in serum interleukin 4 concentrations was associated with a 10-fold decrease in the estimated odds of having severe anaemia (P = 0.023). Increasing serum interleukin 10 concentrations, measured in less than half of the subjects, were associated with a nonsignificant reduction in the odds of having severe anaemia (P = 0.095).

CONCLUSION   Development of severe malarial anaemia may be directly associated with serum neopterin concentrations and inversely correlated with serum interleukin 4 levels.

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