Relationship between Serum C-reactive Protein Levels and Severity of Plasmodium falciparum Malaria in Children Seen in South-South Nigeria

Abstract

Aim: To determine the relationship between serum C-reactive protein levels and severity of malaria infection in children aged six months to five years in a malaria endemic setting. Study Design: A prospective cross-sectional study. Place and Duration of Study: This study was carried out in the Children Out-patient (CHOP) Clinic, Children Emergency Unit (CHEU), Child Welfare/Growth Monitoring Clinic, Immunization Centre and main Paediatric Ward of the University of Uyo Teaching Hospital (UUTH), Uyo in Akwa-Ibom State. It was conducted over a six month period. Methodology: We studied three hundred and sixty (360) children with microscopically confirmed Plasmodium falciparum malaria and three hundred and sixty (360) healthy controls matched for age and gender. Their serum C-reactive protein levels were measured using the highly sensitive Enzyme Linked Immunosorbent assay (ELISA). Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 17.0. Results: The serum C-reactive protein levels showed a positive correlation with the malaria parasite count (r = 0.55; p < 0.001). Children presenting with severe manifestations of malaria had significantly higher mean serum C-reactive protein levels (33.3± 6.88mg/l) than the 8.12±9.09mg/l obtained in those with uncomplicated malaria (t = -15.57; p = 0.001. Conclusion: This study shows that C-reactive protein levels are increased in children with malaria, especially in severe malaria. Its estimation therefore holds potential usefulness as an adjunct for assessment of malarial severity.