Liver enzymes and lipid profile of malaria patients before and after antimalarial drug treatment at Dembia Primary Hospital and Teda Health Center, Northwest, Ethiopia

Abstract

Backgroundinfection with malaria in humans involves liver cell destruction, which alters the levels of liver enzymes and lipid profiles. Although a number of studies have been conducted to address the impact of malaria on liver enzymes and lipid profiles, their findings lack consistency and no studies were conducted after antimalarial drug treatment in the Ethiopian context. This study, therefore, is intended to fill this gap. MethodsAn observational cohort study was conducted at Dembia Primary Hospital and Teda Health Center, from June to August 2020. A total of 88 study participants were recruited using random sampling techniques. Socio-demographic data, capillary and venous blood samples were collected from confirmed Plasmodium -infected individuals. Assessment of liver enzymes and lipid profiles was done using Beckman Coulter DC-700 clinical chemistry analyzer. Data were entered using Epi-data and exported to SPSS version 20 software for analysis. One way ANova, independent t-test, and paired t-test were used to compare the mean liver enzymes and lipid profile. A p -value<0.05 was considered statistically significant. RESULTSBefore anti-malaria treatment, among 88 malaria-infected study participants, abnormally elevated AST was observed in 87.5% of them. Similarly, elevated ALT, ALP, and TG were observed among 12.5%, 43.2%, and 17.2% of the study subjects, respectively. A lower level of HDL was observed among 87.5% of the study participants, while LDL and TC levels were within the normal range. After anti-malaria treatment,100% of AST, ALT, HDL, and LDL, and 92% of ALP, 94.3% of TC, and 86.4% of TG results were in the normal range. The mean level of AST (39.70±3.55and 55.35±9.6) and ALT (22.11±11.75, and23.24±16.05) results were increased, whereas HDL (28.88±11.63and22.73±14.26) level decreased from low to higher density parasitaemia. The mean level of AST at posttreatment (33.90±15.15) was significantly lower compared to the pretreatment (47.60±9.65). The mean levels of ALT had not altered during pretreatment(23.53±16.28)and posttreatment (23.49±11.10).Moreover, the mean of HDL, LDL, and TC at posttreatment were found to be increased when compared with pretreatment, though it is statistically insignificant ( P >0.05). CONCLUSIONMalaria parasites could be responsible for increased liver enzymes and certain lipids while decreasing some lipid profiles compared with the normal range. After anti-malaria treatment, these parameters were reversed to normal from 86.4% to 100%. When the mean values are compared, a significant change was observed in AST level while ALT level remains the same. Hence, prompt treatment is important to improve liver enzymes and lipid profile impairment during malaria infection.