Correlation of malaria parasitaemia with peripheral blood monocyte to lymphocyte ratio as indicator of susceptibility to severe malaria in Ghanaian children

Abstract

BackgroundEven though malaria is generally on the decline due extensive control and elimination efforts, it still remains a public health problem for over 40% of the world’s population. During the course of malaria infection, parasites and red blood cells come under oxidative stress and there is host immune response in an attempt to protect the red blood cells. The frequency of monocytes and lymphocytes in peripheral blood might, therefore, be expected to reflect the state of an individual’s immune response to the infection. Circulating monocytes and lymphocytes could therefore serve as an index in relation to malaria parasitaemia. The purpose of this study was to determine whether the relative count of monocytes to lymphocytes in peripheral blood (M:L ratio) can predict parasitaemia and, therefore, the severity of malaria infection.MethodsTwo millilitre of venous blood sample were taken from participants by venisection into anticoagulant tubes. Thick and thin blood films were made and stained with Giemsa and examined for malaria parasites. Whole blood specimen were analysed for full blood count using ABX Pentra 60 C+ automated haematological analyzer. Data was entered into Microsoft Word and analysed using Statistical Package for Social Sciences (SPSS, Version 20.0) and Graphpad prism. Spearman’s correlation was used to determine correlation between occurrences of clinical malaria and the monocytes and lymphocytes ratio. Statistical significance was taken as p ≤ 0.05 with 95% confidence interval.ResultsThe study comprised of 1629 (m = 896; f = 733) children up to 5 years presenting with clinical malaria as cases and 445 (m = 257; f = 188) apparently healthy children as controls. The results indicated that there was a significant positive correlation between the monocytes to lymphocytes ratio and the presence of parasites (p = 0.04) and the level of parasitaemia within the age group of 0–3 years (p = 0.02) and 4–5 years (p = 0.03).ConclusionsThe monocyte to lymphocyte ratio obtained correlated positively with the presence of malaria as well as the level of parasitaemia. The outcome of this work implies that monocyte to lymphocyte ratio can be used to predict the level of parasitaemia and together with other factors, the development of severe malaria.

Association of Parasite Density and Hematological Parameters of Plasmodium vivax- and Plasmodium falciparum-infected Patients Attending Merauke General Hospital, Papua, Indonesia

“…A mathematical model study also designated good relationships of the parasite density with neutrophil, lymphocyte, monocyte, and eosinophil count in P. falciparum infection [17]. Despite those discordances, insignificant correlations of parasite density, in both species, with hemoglobin concentration, leukocyte count, and monocyte count, in this study, agree with the previous studies [3], [7]. Interestingly, the positive correlation of eosinophil count and parasite density in P. vivax group seems becoming a new finding referring to those studies.…”

“…These results appear contrary to some studies that indicated several significant correlations. An inverse correlation between the parasite densities with the lymphocyte count in P. falciparum infection and positive correlations of the parasite density with neutrophil and platelet counts in P. vivax and P. falciparum infection were reported by studies in Ghana and South Ethiopia [3], [7]. A mathematical model study also designated good relationships of the parasite density with neutrophil, lymphocyte, monocyte, and eosinophil count in P. falciparum infection [17].…”

“…Hemoglobin, erythrocyte, total leukocyte, neutrophil, eosinophil, monocyte, and lymphocyte counts seemed significantly lower contrasted with non-malaria patients [3], [4]. Meanwhile, erythrocyte indices, neutrophillymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR) were higher opposed to non-malaria patients [5], [7]. Leukocyte, neutrophil, monocyte, lymphocyte, erythrocyte, and platelet counts among different levels of parasitemia levels also marked to differ significantly [5].…”

Nonlethal Plasmodium yoelii Infection Drives Complex Patterns of Th2-Type Host Immunity and Mast Cell-Dependent Bacteremia

“…4E ). The monocyte to lymphocyte ratio has been used as a marker of infection in a range of diseases ( 54 – 56 ), including malaria, where positive correlations with parasitemia and severe disease have been noted ( 57 , 58 ). Relative to controls, monocyte to lymphocyte ratios were significantly increased by day 4 p.i.…”

Diagnostic and prognostic value of thrombocytopenia severity in Sudanese children with Falciparum malaria

“…Falciparum malaria associated with several hematological changes that involve the major blood cell lines such as red blood cells, white blood cells and platelets (6,7), which play a significant role in severity of falciparum malaria (8,9). Malaria hematological changes arising from hemolysis, host immune (inflammatory) response, bone marrow suppression, and splenic pooling (10).…”