SOURCE:

Faculty: Health Sciences And Technology
Department: Medical Laboratory Science

CONTRIBUTORS:

Okamgba, O. C.
Ekejindu, M. I.
Ifeanyichukwu, M. O.

ABSTRACT:

Malaria is a plasmodial infection that has the propensity to induce immune activation with subsequent release of cytokines.Similarly, iron replete state is a non-infectious condition that may illicit immune stimulation which results in the secretion of cytokines.The study was aimed at determining the relationship between levels ofcytokines, iron and malaria parasite density. The subjects comprised a total of 206 pregnant women (144 malaria parasitaemicand 62 aparasitaemic), 50 post-partum women (30 malaria infectedplacenta and 20 nonmalaria infected placenta) and control (20 malaria infected and 20 malaria uninfected non-pregnant women). These subjects tested negative to HIV. The test groups were asymptomatic subjects and control groups were apparently healthy subjects. All were between ages 17 and 44 years. Ethical approval for the study was obtained from Ethics Committee of Abia State University Teaching Hospital and Living Word Mission Hospital, in Aba. Informed consent of the participantswas obtained. Malaria and malaria parasite density were determined by the Thick Film Technique. Full blood count and red cell indices were evaluated using Sysmex Automated Haematology Analyzer model KX2IN series. Interferon-gamma, TNF-, IL-4, IL-6, IL-10, sTfR and SF were measured by ELISA Technique. The values of SF and sTfR were used to derive values ofsTfR-F Index. The turbidimetric method was used to measure C - reactive proteinwhile estimations of glucose andcreatinine were by Colorimetric method. Comparisons of groups were done by Analysis of Variance and Student’s t-test while Pearson’s Correlation Coefficient was used for tests of association.The Mean Parasite Density in the peripheral and placental blood was 685.56 ± 484.55 parasite/µl and 762.47 ± 459.62 parasite/µl of blood respectively but did not differ significantly on comparison (P>0.05). Malaria infected pregnant women showed significantly elevated levels of IFN, TNF, IL-4, IL-6, IL-10 when compared with their non-infected counterparts (P<0.05). Infected placenta showed significantly increased levels of IFN, TNF and IL-10 (P<0.05) while IL-4 and IL-6 were increased but was not significant when compared with the uninfected placenta (P>0.05). Interferon-gamma was significantly lower in the peripheral than the placenta (P<0.05)while IL-4 and IL-10 were significantly higher in the placenta than the peripheral blood (P<0.05). The cytokines were higher in moderate parasitaemia than mild parasitaemia however, TNF, IL-4 and IL-10 were not significant (P>0.05). Haemoglobin concentration was lower in the infected but not significant on comparison with the uninfected pregnant subjects (P>0.05). SF was higher in the infected however showed no statistical difference in comparison with the uninfected (P>0.05). Soluble transferrin receptor and C-RP were significantly higher in the infected than uninfected pregnant women (P<0.05). Positive correlation existed between malaria parasite density and IL-6 (r = 0.66, p = 0.001) and between IL-10 and C-RP (r = 0.79, p = 0.001). Conversely,there was strong negative correlation between IFN- andHb (r=-0.82, p=0.03). However, weak negative correlation existed between TNF-α and Hb (r= - 0.162, p= 0.04). This study has shown that malaria parasite density in the placenta is higher than the systemic blood. Moreover, malariaparasitaemia induces increased secretion of cytokines and synthesis of acute phase proteins which in turn may compromiseiron metabolism. This could contribute to most adverse conditions in pregnancy and post-partum women. Again, the levels of secretion of cytokines was not influenced by age, gestational age and gravidity.