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Plasma angiopoietin-2 is associated with age-related deficits in cognitive sub-scales in Ugandan children following severe malaria.
Ouma, Benson J; Bangirana, Paul; Ssenkusu, John M; Datta, Dibyadyuti; Opoka, Robert O; Idro, Richard; Kain, Kevin C; John, Chandy C; Conroy, Andrea L.
Afiliación
  • Ouma BJ; Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Bangirana P; Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Ssenkusu JM; Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, Kampala, Uganda.
  • Datta D; Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Opoka RO; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
  • Idro R; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
  • Kain KC; Centre of Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
  • John CC; Department of Medicine, University of Toronto and University Health Network, Toronto, Canada.
  • Conroy AL; Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA.
Malar J ; 20(1): 17, 2021 Jan 06.
Article en En | MEDLINE | ID: mdl-33407493
BACKGROUND: Elevated angiopoietin-2 (Angpt-2) concentrations are associated with worse overall neurocognitive function in severe malaria survivors, but the specific domains affected have not been elucidated. METHODS: Ugandan children with severe malaria underwent neurocognitive evaluation a week after hospital discharge and at 6, 12 and 24 months follow-up. The relationship between Angpt-2 concentrations and age-adjusted, cognitive sub-scale z-scores over time were evaluated using linear mixed effects models, adjusting for disease severity (coma, acute kidney injury, number of seizures in hospital) and sociodemographic factors (age, gender, height-for-age z-score, socio-economic status, enrichment in the home environment, parental education, and any preschool education of the child). The Mullen Scales of Early Learning was used in children < 5 years and the Kaufman Assessment Battery for Children 2nd edition was used in children ≥ 5 years of age. Angpt-2 levels were measured on admission plasma samples by enzyme-linked immunosorbent assay. Adjustment for multiple comparisons was conducted using the Benjamini-Hochberg Procedure of False Discovery Rate. RESULTS: Increased admission Angpt-2 concentration was associated with worse outcomes in all domains (fine and gross motor, visual reception, receptive and expressive language) in children < 5 years of age at the time of severe malaria episode, and worse simultaneous processing and learning in children < 5 years of age at the time of severe malaria who were tested when ≥ 5 years of age. No association was seen between Angpt-2 levels and cognitive outcomes in children ≥ 5 years at the time of severe malaria episode, but numbers of children and testing time points were lower for children ≥ 5 years at the time of severe malaria episode. CONCLUSION: Elevated Angpt-2 concentration in children with severe malaria is associated with worse outcomes in multiple neurocognitive domains. The relationship between Angpt-2 and worse cognition is evident in children < 5 years of age at the time of severe malaria presentation and in selected domains in older years.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Malaria Falciparum / Cognición / Angiopoyetina 2 Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Malar J Asunto de la revista: MEDICINA TROPICAL Año: 2021 Tipo del documento: Article País de afiliación: Uganda

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Malaria Falciparum / Cognición / Angiopoyetina 2 Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Malar J Asunto de la revista: MEDICINA TROPICAL Año: 2021 Tipo del documento: Article País de afiliación: Uganda