Study of Lipid Profile in Malaria- A Prognostic Factor

Abstract

BACKGROUND Malaria is one of the most important parasitic infections human beings have ever known. Malaria is endemic in 91 countries with about 40% of world's population at risk of acquiring the infection. Severe malaria is a medical emergency requiring immediate hospitalization and needs prompt treatment at the earliest. Transitory changes in the plasma levels of lipids, cholesterol and triglycerides have been observed and are related to the severity of malaria. The objectives of the study are-1. to find out incidence of lipid abnormalities in malaria, pyrexia other than malaria and controls. 2. to collect a detailed lipid profile in malaria with objective of noting its abnormalities and correlation if any with clinical severity and prognosis. MATERIALS AND METHODS The study is a prospective study done in the department of medicine SVS medical college, Mahbubnagar. A total of 100 Malaria positive cases, 50 cases of Pyrexia other than malaria cases, 50 healthy controls were included. All information pertaining to history, clinical examination, complications, relevant investigations, treatment modalities were noted, analysed and tabulated; especially with reference to lipid profile. Appropriate statistical methods were used to find the statistically significant observations. RESULTS Out of 100 cases there were 59 males (59%), and 41 females (41%).The mean age of entire study group was 37.48. The most common clinical presentation was fever (100%), followed by nausea and vomiting. The most common clinical signs were pallor (42%), splenomegaly (46%), hepatomegaly (44%) and CNS manifestations (16%).Thrombocytopenia (78%) and anaemia (42%) were the most common haematological findings. At presentation, the total cholesterol (mean total cholesterol 106.92mg/dl) and HDL (mean HDL20.31) were significantly reduced. Though LDL (mean LDL 57.71) and VLDL (mean VLDL 28.96 mg/dl) were also reduced, statistically significant difference was not observed. There was no significant change in triglyceride levels CONCLUSION All patients with severe malaria were found to be associated with lipid abnormalities especially of total cholesterol, HDL and LDL levels and values revert to normal once parasitaemia is cleared. This finding suggests the importance of estimating the lipid abnormalities as a diagnostic and prognostic factor in severe malaria cases.