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Markers of inflammation in children with severe malarial anaemia

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OBJECTIVE   To investigate if severe malarial anaemia is associated with a specific immune response pattern, we determined serum levels of neopterin (a marker of activation of macrophages by interferon-γ) and of the anti-inflammatory cytokines, interleukins 4 and 10.

METHODS   Zambian children < 6 years of age presenting to a rural hospital with cerebral malaria were studied. Twenty-one children with admission haemoglobin concentrations ≤ 5 g/dl were classified as having severe anaemia and 40 with haemoglobin concentrations ≥ 7 g/dl served as a control group.

RESULTS   Logistic regression modelling indicated that a 10-fold rise in serum neopterin concentrations was associated with a 50-fold increase in the estimated odds of having severe anaemia (= 0.015), while a 10-fold rise in serum interleukin 4 concentrations was associated with a 10-fold decrease in the estimated odds of having severe anaemia (= 0.023). Increasing serum interleukin 10 concentrations, measured in less than half of the subjects, were associated with a nonsignificant reduction in the odds of having severe anaemia (= 0.095).

CONCLUSION   Development of severe malarial anaemia may be directly associated with serum neopterin concentrations and inversely correlated with serum interleukin 4 levels.

Keywords: Zambia; anaemia; interleukin 10; interleukin 4; malaria; neopterin

Document Type: Research Article


Affiliations: 1: Department of Medicine, Howard University, Center, Washington DC, USA 2: Department of Natural Sciences, Messiah College, Grantham, USA 3: Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria

Publication date: April 1, 2000


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