Some biochemical changes In children with Acute Falciparum Malaria

Abstract

One hundred children with acute falciparum malaria attending Kenyatta National Hospital and 75 controls matched for age and sex, were the subjects of the study. Seventy five patients were compared with 75 available controls. Of the 75 patients compared, 25 (33.3%) were within the 6 - 12 month age group. An overall majority 67 (90.7%) were under the age of 5 years. The study was conducted in the Paediatric Emergency Ward (P.E.W.) of K.N.H.

From each subject of the study, venous blood was obtained and analysed for various biochemical parameters. Electrolytes, sodium and potassium, blood urea nitrogen, alanine and aspartate tr~nsaminases (ALT and AST) and blood glucose concentrations were compared between the two groups~ Total bilirubin for a few patients, who were jaundiced and non jaundiced and for their controls was determined.

It was found that the malaria patients had significantly lower sodium levels than the controls, with 16% being hyponatraemic. There was no statistical difference in potassium levels. The BUN concentrations, ALT and AST levels were significantly raised in the malaria patients, with greater elevation in ALT than AST levels. All the differences noted above were statistically significant (P<0.05). The jaundiced patients had a higher elevation in ALT, AST and higher parasite counts but lower haemoglobin levels (P<0.05). Blood glucose levels for the patients with malaria were mostly in the fasting range. The patient levels were -much lower than for the controls and this was highly significant (P<0.001). Two patients (2%) were found to be hypoglycaemic.

No significant correlation existed between parasite count and sodium,potassium, BUN, ALT and AST levels. Parasite count was inversely correlated to blood glucose level, with hypoglycaemia being associated with high parasite count (r:o.594). This was found to be highly significant (p<O.OOl) statistically.

An attempt to correlate biochemical changes and overall outcome was difficult to do from this particular study. It was concluded that some significant biochemical changes do occur in children with acute falciparum malaria with exception~ IEgarrnpotassium levels. Hypoglycaemia is likely to occur with increased parasite counts and should be anticipated.