Plasma Plasmodium falciparum Histidine-Rich Protein-2 Concentrations Are Associated with Malaria Severity and Mortality in Tanzanian Children
Plasma Plasmodium falciparum Histidine-Rich Protein-2 Concentrations Are Associated with Malaria Severity and Mortality in Tanzanian Children
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DOI：
10.1371/journal.pone.0035985
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发表时间：
2012-05-07
期刊：
影响因子：
3.7
通讯作者：
Mwaikambo, Esther D.
中科院分区：
文献类型：
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作者：
Rubach, Matthew P.;Mukemba, Jackson;Mwaikambo, Esther D.
血浆恶性疟原虫富含组氨酸蛋白 2 (PfHRP-2) 浓度是衡量寄生虫生物量的指标，已与成人疟疾严重程度相关，但在儿童中尚无相关性。我们测量了坦桑尼亚无并发症儿童 (n = 61) 和脑型疟疾 (n = 45；7 例死亡) 的血浆 PfHRP-2。脑型疟疾中血浆 PfHRP-2 浓度中位数 (1008 [IQR 342-2572] ng/mL) 高于无并发症疟疾 (465 [IQR 36-1426] ng/mL；p = 0.017)。在脑型疟疾中，自然对数血浆 PfHRP-2 与昏迷深度 (r = -0.42；p = 0.006) 和死亡率 (OR：3.0 [95% CI 1.03-8.76]；p = 0.04) 相关。在非洲中流行传播地区进行的这项相对较小的队列研究中，血浆 PfHRP-2 与儿童疟疾的严重程度和死亡率相关。对非洲疟疾传播较高地区的儿童以及具有不同严重疟疾临床表现的儿童进行的进一步研究将有助于确定定量 PfHRP-2 作为衡量撒哈拉以南非洲寄生虫生物量和预后的指标的更广泛用途。
Plasma Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) concentrations, a measure of parasite biomass, have been correlated with malaria severity in adults, but not yet in children. We measured plasma PfHRP-2 in Tanzanian children with uncomplicated (n = 61) and cerebral malaria (n = 45; 7 deaths). Median plasma PfHRP-2 concentrations were higher in cerebral malaria (1008 [IQR 342-2572] ng/mL) than in uncomplicated malaria (465 [IQR 36-1426] ng/mL; p = 0.017). In cerebral malaria, natural log plasma PfHRP-2 was associated with coma depth (r = -0.42; p = 0.006) and mortality (OR: 3.0 [95% CI 1.03-8.76]; p = 0.04). In this relatively small cohort study in a mesoendemic transmission area of Africa, plasma PfHRP-2 was associated with pediatric malaria severity and mortality. Further studies among children in areas of Africa with higher malaria transmission and among children with different clinical manifestations of severe malaria will help determine the wider utility of quantitative PfHRP-2 as a measure of parasite biomass and prognosis in sub-Saharan Africa.