Evaluation of Haemato-Biochemical Parameters and Serum Levels of 8-Iso-Prosta-glandin F2α Oxidative Stress Biomarker in Sickle Cell-Malaria Comorbidity

Abstract

Blood (5ml) was collected from suspected malaria patients (n=2272) into K3-EDTA tube. Samples were grouped as malaria infections in normal haemoglobin (malaria-HbAA), malaria infections in sickle cell disease (malaria-SCD), malaria infections in sickle cell trait (malaria- SCT) and non-malaria with normal haemoglobin (controls). The aim of the study was to evaluate the effect of Plasmodium falciparum infections on haematological, biochemical profiles and oxidative stress in sickle cell patients as paucity of data exist in this regard. Malaria parasites were identified and quantified according to WHO guidelines. All eligible samples were assayed for haematological and biochemical parameters, T-cell profiling and levels of 8-iso-prostaglandin F2α oxidative stress biomarker. The study found that geometric mean of parasite density was higher in malaria-HbAA than malaria-SCD (20394 parasites/µl vs. 9990 parasites/µl, p=0.001) whilst mean body temperature was higher in malaria-SCD and malaria-HbAA than control samples and malaria-SCT. Mean leukocytes were significantly elevated in co-morbidity states while lymphopenia and neutrophilia were associated with malaria-HbAA and malaria-SCD. However, CD3+, CD4+ and CD8+ T cells were significantly higher in malaria-HbAA than malaria-SCD. Eosinophilia was also associated with malaria-SCT while monocytosis was seen in malaria- SCD. Severely low red blood cells, low haemoglobin concentrations and low red cell indices were seen in malaria-SCD with corresponding significant elevations in plasma haemoglobin, % haemolysis, serum potassium, serum bilirubin and lactate dehydrogenase in malaria- SCD. Levels of means 8-iso-prostaglandin F2α in all the patient groups were significantly higher than the control sample with compounding levels seen in malaria-SCD group. In conclusion, severe haemolysis was observed in malaria-SCD co-morbidity which associated with compounding oxidative stress. Exhaustive clinical assessment must be done to prevent or reduce oxidant related pathologies in SCD patients