Oxidative Stress and Hemoglobin Level of Complicated and Uncomplicated Malaria Cases among Children: A Cross-Sectional Study in Kumasi Metropolis, Ghana

Abstract

Introduction. Malaria is a leading cause of mortality among children below 5 years in Ghana. Its parasites are known to cause the degradation of hemoglobin, resulting in the production of reactive oxygen species and hence oxidant stress. Therefore, this study was carried out to compare the levels of oxidative stress between children with complicated and uncomplicated malaria infection in Kumasi, Ghana. Method. Subjects were recruited from hospitals in the Kumasi Metropolis. This was a cross-sectional study, involving 17 complicated malaria subjects, 51 uncomplicated malaria subjects, and 15 nonparasitemic subjects. The rapid diagnostic test (RDT) was used to determine presence or absence of falciparum malaria among the study participants. Blood samples from subjects were used to determine hemoglobin, malondialdehyde (MDA), and vitamin C levels. Results. Majority of the subjects (67.5%) were within the age of 0-5 years. The mean age (±SD) of uncomplicated malaria subjects was 4.32 (±2.81) years, while that of complicated malaria was 4.27 (±2.96). Mean levels of HB decreased significantly in the following order: control subjects > uncomplicated malaria subjects > complicated malaria subjects (p<0.0001). Mean levels of MDA were significantly lower in control subjects compared to complicated malaria subjects (4.62±1.85 versus 6.68±0.70, p=0.0008) and also lowered in uncomplicated malaria subjects compared to complicated malaria (4.50±1.58 versus 6.68±0.70, p<0.0001). There was a statistically significant reduced mean level of vitamin C (p=0.036) in the following order: control subjects > uncomplicated malaria > complicated malaria subjects. However, for the complicated malaria cases, there were significantly higher mean vitamin C levels in females than in males (p<0.001). Conclusion. Malaria progression increases MDA levels and decreases the ascorbate (vitamin C) and hemoglobin levels. It is recommended that future studies should investigate changes in other antioxidant vitamins, like vitamins A and E.

Evaluation of red blood cell count as an ancillary index to hemoglobin level in defining the severe falciparum malarial anemia among Ghanaian children in low-resource communities

“…Malaria is one of the most common infectious diseases in the world and one of the greatest global public health problems [ 1 ], mostly among children under 5 years [ 2 ]. About 90% of the world's severe and fatal malaria is projected to affect young children in sub-Saharan Africa [ 3 ], as major complications of severe falciparum malaria (SFM) develop rapidly and progress to death within hours or days [ 4 ].…”

Expression of 4-Hydroxynonenal (4-HNE) and Heme Oxygenase-1 (HO-1) in the Kidneys of Plasmodium berghei-Infected Mice

“…Oxidative stress is considered a determinant of disease severity during P. falciparum malaria infection and increases during disease progression [ 21 – 23 ]. Malaria-associated AKI has been proposed as a consequence of parasite adhesion and an exacerbated immune response against the products of oxidative stress released during Plasmodium infection [ 24 ].…”

Immunological and Anti-oxidant Profiles of Malarial Children in Abuja, Nigeria

“…There is a release of biomarkers of oxidative stress such as reactive oxygen species (ROS) and reactive nitrogen species (RNS) via host-parasite interaction. This ultimately stimulates the immune system with the possibility of causing red cell destruction through the induction of oxidative damages [12]. Therefore, red blood cells infected with plasmodium parasite are under constant oxidative stress utilized by the parasite with a resultant rise in antioxidant levels in the blood [12].…”

“…While some studies suggested that oxidative stress during malaria plays a protective role, others opposed that it plays a deleterious role by worsening the pathological outcome of the infection [12]. In malaria, oxidative stressors levels such as malondialdehyde (MDA) and superoxide (SOD) are higher while catalase levels are lower [11,12].…”

“…While some studies suggested that oxidative stress during malaria plays a protective role, others opposed that it plays a deleterious role by worsening the pathological outcome of the infection [12]. In malaria, oxidative stressors levels such as malondialdehyde (MDA) and superoxide (SOD) are higher while catalase levels are lower [11,12]. Due to the production and accumulation of peroxide (H 2 O 2 ) through the activity of SOD and catalase, capable of reacting with several molecules to form free radicals, there is a need to remove these radicals using substances with anti-oxidant properties such as the ascorbic acid.…”