Evolución temporal de las plaquetas y los anticuerpos antiplaquetarios en pacientes de área endémica con malaria no complicada / Temporal evolution of platelets and anti-platelets antibodies in patients of endemic area with non complicated malaria

Objetivo: evaluar plaquetas y anticuerpos antiplaquetarios IgG Ac-Pl (medidos por citometría de flujo) en pacientes de Turbo (Antioquia, Colombia) con paludismo no complicado. Metodología: estudio descriptivo, prospectivo y longitudinal de 45 pacientes (14-67 años). Treinta enfermos se siguieron 7 días. Resultados: A) Pretratamiento: hubo trombocitopenia malárica (TM) en 71% y Ac-Pl en 33%, con asociación significativa entre TM y Ac-Pl. La TM no se asocia con zona de residencia, haber tenido malaria en último año ni especie actual de Plasmodium, pero si con sexo (hombres) (p = 0,02078195), pero la concentración de Ac-Pl es similar en hombres y mujeres. Igualmente, la cantidad de plaquetas es estadísticamente igual entre los valores de las variables anteriores. La presencia de Ac-Pl no se relacionó con las anteriores variables. Hay baja e inversa correlación lineal entre plaquetas y Ac-Pl (r = -0,342 (p = 0,02310). B) Durante el seguimiento, la regresión lineal múltiple entre plaquetas y edad, años de residencia, número de episodios de malaria en el último año, parasitemia (expresada logarítmicamente) y concentración de Ac-Pl demostró que ningún coeficiente es significativo y la máxima explicación lograda (17%) la dan la parasitemia y los Ac-Pl. El mismo análisis entre Ac-Pl y edad, años de residencia en la zona, número de episodios de malaria en el último año, parasitemia (expresada logarítmicamente) demostró que las tres primeras explican 38% de los cambios en Ac-Pl, mientras que los episodios de malaria y el tiempo de residencia en la zona explican el 28%

Aim: To evaluate the number of platelets and the title of anti-platelet antibodies IgG Ac-PI (by flow cytometry) in patients with non-complicated malaria. Methods: Descriptive, prospective and longitudinal study from 45 patients (aged among 14-67). Thirty patients were followed during 7 days. Results: A) Pretreatment: it was found malarial thrombocytopenia (MT) in 71 % and significant association between MT and Ac-PI in 33 %. MT was not associated to residence zone, to have had malaria in the last year and Plasmodium species but sex associated (males, p= 0,02078195), although, the Ac-PI titers of male and female was similar. Correspondingly, the number of platelets was statistically similar to the values of above variables. There was a low and an inverse lineal correlation between platelets and titres of Ac-P1 (r= -0,342 (p= 0,02310)). B) During the following, multiple linear regression among platelets, age, years of residence in the zone, number of malaria episodes in the last year, parasitaemia (logarithmically expressed) and Ac-P1 titers showed no significant coefficient and the maximum explanation achieved (17%) was parasitaemia and Ac-P1 titers. Similar analysis among Ac-P1 and age, years of residence in the zone number of malaria episodes in the last year, parasitaemia (logarithmically expressed) showed that the first three explain 38 % of the changes in Ac-P1, whereas malaria episodes and years of residence in the zone explain 28%

[Temporal evolution of platelets and anti-platelet antibodies in patients of endemic area with non complicated malaria]. / Evolución temporal de las plaquetas y los anticuerpos antiplaquetarios en pacientes de área endémica con malaria no complicada.

AIM: To evaluate the number of platelets and the title of anti-platelet antibodies IgG Ac-PI (by flow cytometry) in patients with non-complicated malaria. METHODS: Descriptive, prospective and longitudinal study from 45 patients (aged among 14-67). Thirty patients were followed during 7 days. RESULTS: A) Pretreatment: it was found malarial thrombocytopenia (MT) in 71 % and significant association between MT and Ac-PI in 33 %. MT was not associated to residence zone, to have had malaria in the last year and Plasmodium species but sex associated (males, p= 0.02078195), although, the Ac-PI titers of male and female was similar. Correspondingly, the number of platelets was statistically similar to the values of above variables. There was a low and an inverse lineal correlation between platelets and titres of Ac-P1 (r= -0.342 (p= 0.02310)). B) During the following, multiple linear regression among platelets, age, years of residence in the zone, number of malaria episodes in the last year, parasitaemia (logarithmically expressed) and Ac-P1 titers showed no significant coefficient and the maximum explanation achieved (17%) was parasitaemia and Ac-P1 titers. Similar analysis among Ac-P1 and age, years of residence in the zone number of malaria episodes in the last year, parasitaemia (logarithmically expressed) showed that the first three explain 38 % of the changes in Ac-P1, whereas malaria episodes and years of residence in the zone explain 28%.

[Nutritional status and immunoglobulin and cytokine concentrations in children with malaria]. / Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria.

OBJECTIVES: To relate nutritional status and concentrations of immunoglobulins and cytokines in children with malaria from two areas with different risk of malaria transmission. METHODS: We performed a descriptive, cross-sectional study comparing children aged 4-11 years old from two areas with different risk of malaria transmission in Colombia. The sample consisted of 66 children from El Bagre and Zaragoza (high transmission area) and 62 children from Turbo (low transmission area). To determine the risk of undernutrition, height/weight, age/height and weight/age indexes were calculated, and serum concentrations of interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), total IgE and malaria-specific IgE were measured. RESULTS: In the high transmission area, concentrations of total and specific IgE and of TNF-alpha were significantly higher. In both areas, the values obtained for total IgE (84 %), specific-IgE (32 %), TNF-alpha (72 %) and IL-10 (84 %) were higher than standard values. Anthropometric indicators revealed acute undernutrition (wasting) in 33 %, chronic undernutrition (stunting) in 52 %, and global undernutrition in 56 % of the population. CONCLUSIONS: Malaria and protein-energy malnutrition were highly prevalent in both areas. In children from the low transmission area, stunting was significantly greater. In the high transmission area, the mean total IgE was twice that found in the low transmission area and no association with nutritional status was observed. Levels of specific IgE did not differ according to the species of Plasmodium infection.

Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria / Nutritional status and immunoglobulin and cytokine concentrations in children with malaria

Objetivos: Relacionar el estado nutricional y los niveles de inmunoglobulinas y citocinas en niños maláricos de dos zonas con diferente riesgo para malaria. Métodos: Mediante un estudio descriptivo transversal se compararon 2 grupos de niños entre 4-11 años de edad procedentes de dos zonas con diferente riesgo para malaria en Colombia: 66 niños de los municipios de El Bagre y Zaragoza (zona de mayor riesgo malárica) y 62 niños de Turbo (zona de menor riesgo). Se calcularon los índices peso/talla, talla/edad y peso/edad para establecer el riesgo de desnutrición y se midieron concentraciones séricas de interleucina 10 (IL-10), factor de necrosis tumoral alfa (TNF- ), inmunoglobulina E (IgE) total e IgE específica para malaria. Resultados: En la zona de mayor riesgo fueron significativamente mayores los niveles de IgE total, IgE específica, y TNF- .Ambas zonas presentaron niveles superiores a los establecidos por los estándares para IgE total (84 por ciento), IgE específica (32 por ciento), TNF- (72 por ciento) e IL-10 (84 por ciento). Los riesgos de desnutrición fueron: aguda, 33 por ciento; crónica, 52 por ciento, y global, 56 por ciento. Conclusiones: La malaria y la desnutrición coexisten con alta frecuencia en ambas zonas. En la zona de menor riesgo malárico hay significativamente más desnutrición crónica. El promedio de IgE total en la zona de mayor riesgo malárico es el doble del que existe en la zona de menor riesgo y no hay asociación con el estado nutricional. Los valores de IgE específica no difieren por especie de Plasmodium infectante (AU)