Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children.
<h4>Background</h4>Severe malaria is difficult to differentiate from other forms of malaria or other infections with similar symptoms. Any parameter associated to malaria-attributable severe disease could help to improve severe malaria diagnosis.<h4>Methodology</h4>This study...
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2011
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oai:doaj.org-article:52a5417d45a64bc9a03c6d52ff10d8382021-11-18T06:47:03ZErythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children.1932-620310.1371/journal.pone.0024090https://doaj.org/article/52a5417d45a64bc9a03c6d52ff10d8382011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21912616/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Severe malaria is difficult to differentiate from other forms of malaria or other infections with similar symptoms. Any parameter associated to malaria-attributable severe disease could help to improve severe malaria diagnosis.<h4>Methodology</h4>This study assessed the relation between erythropoietin (EPO) and malaria-attributable severe disease in an area of Mozambique with moderate malaria transmission. 211 children <5 years, recruited at Manhiça District Hospital or in the surrounding villages, were included in one of the following groups: severe malaria (SM, n = 44), hospital malaria without severity (HM, n = 49), uncomplicated malaria (UM, n = 47), invasive bacterial infection without malaria parasites (IBI, n = 39) and healthy community controls (C, n = 32). Malaria was diagnosed by microscopy and IBI by blood/cerebrospinal fluid culture.<h4>Principal findings</h4>Mean EPO concentration in the control group was 20.95 U/l (SD = 2.96 U/l). Values in this group were lower when compared to each of the clinical groups (p = 0.026 C versus UM, p<0.001 C vs HM, p<0.001 C vs SM and p<0.001 C vs IBI). In the 3 malaria groups, values increased with severity [mean = 40.82 U/l (SD = 4.07 U/l), 125.91 U/l (SD = 4.99U/l) and 320.87 U/l (SD = 5.91U/l) for UM, HM and SM, respectively, p<0.001]. The IBI group [mean = 101.75 U/l (SD = 4.12 U/l)] presented lower values than the SM one (p = 0.002). In spite of the differences, values overlapped between study groups and EPO levels were only associated to hemoglobin. Hemoglobin means of the clinical groups were 93.98 g/dl (SD = 14.77 g/dl) for UM, 75.96 g/dl (SD = 16.48 g/dl) for HM, 64.34 g/dl (SD = 22.99 g/dl) for SM and 75.67 g/dl (SD = 16.58 g/dl) for IBI.<h4>Conclusions</h4>Although EPO levels increase according to malaria severity and are higher in severe malaria than in bacteremia, the utility of EPO to distinguish malaria-attributable severe disease is limited due to the overlap of values between the study groups and the main role of hemoglobin in the expression of EPO.Núria Díez-PadrisaRuth AguilarSonia MachevoLuis MoraisTacilta NhampossaCristina O'Callaghan-GordoDelino NhalungoClara MenéndezAnna RocaPedro L AlonsoQuique BassatPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 8, p e24090 (2011) |
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Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Núria Díez-Padrisa Ruth Aguilar Sonia Machevo Luis Morais Tacilta Nhampossa Cristina O'Callaghan-Gordo Delino Nhalungo Clara Menéndez Anna Roca Pedro L Alonso Quique Bassat Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| description |
<h4>Background</h4>Severe malaria is difficult to differentiate from other forms of malaria or other infections with similar symptoms. Any parameter associated to malaria-attributable severe disease could help to improve severe malaria diagnosis.<h4>Methodology</h4>This study assessed the relation between erythropoietin (EPO) and malaria-attributable severe disease in an area of Mozambique with moderate malaria transmission. 211 children <5 years, recruited at Manhiça District Hospital or in the surrounding villages, were included in one of the following groups: severe malaria (SM, n = 44), hospital malaria without severity (HM, n = 49), uncomplicated malaria (UM, n = 47), invasive bacterial infection without malaria parasites (IBI, n = 39) and healthy community controls (C, n = 32). Malaria was diagnosed by microscopy and IBI by blood/cerebrospinal fluid culture.<h4>Principal findings</h4>Mean EPO concentration in the control group was 20.95 U/l (SD = 2.96 U/l). Values in this group were lower when compared to each of the clinical groups (p = 0.026 C versus UM, p<0.001 C vs HM, p<0.001 C vs SM and p<0.001 C vs IBI). In the 3 malaria groups, values increased with severity [mean = 40.82 U/l (SD = 4.07 U/l), 125.91 U/l (SD = 4.99U/l) and 320.87 U/l (SD = 5.91U/l) for UM, HM and SM, respectively, p<0.001]. The IBI group [mean = 101.75 U/l (SD = 4.12 U/l)] presented lower values than the SM one (p = 0.002). In spite of the differences, values overlapped between study groups and EPO levels were only associated to hemoglobin. Hemoglobin means of the clinical groups were 93.98 g/dl (SD = 14.77 g/dl) for UM, 75.96 g/dl (SD = 16.48 g/dl) for HM, 64.34 g/dl (SD = 22.99 g/dl) for SM and 75.67 g/dl (SD = 16.58 g/dl) for IBI.<h4>Conclusions</h4>Although EPO levels increase according to malaria severity and are higher in severe malaria than in bacteremia, the utility of EPO to distinguish malaria-attributable severe disease is limited due to the overlap of values between the study groups and the main role of hemoglobin in the expression of EPO. |
| format |
article |
| author |
Núria Díez-Padrisa Ruth Aguilar Sonia Machevo Luis Morais Tacilta Nhampossa Cristina O'Callaghan-Gordo Delino Nhalungo Clara Menéndez Anna Roca Pedro L Alonso Quique Bassat |
| author_facet |
Núria Díez-Padrisa Ruth Aguilar Sonia Machevo Luis Morais Tacilta Nhampossa Cristina O'Callaghan-Gordo Delino Nhalungo Clara Menéndez Anna Roca Pedro L Alonso Quique Bassat |
| author_sort |
Núria Díez-Padrisa |
| title |
Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| title_short |
Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| title_full |
Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| title_fullStr |
Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| title_full_unstemmed |
Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. |
| title_sort |
erythropoietin levels are not independently associated with malaria-attributable severe disease in mozambican children. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2011 |
| url |
https://doaj.org/article/52a5417d45a64bc9a03c6d52ff10d838 |
| work_keys_str_mv |
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