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. 2024 Sep;12(9):e70013.
doi: 10.1002/iid3.70013.

Pro- and anti-inflammatory cytokines mediate the progression of severe anemia in malaria-infected children: A prospective study

Charles Nkansah  1   2 , Felix Osei-Boakye  2   3 , Gabriel Abbam  1 , Samuel K Appiah  1   2 , Samira Daud  1 , Bright Boakye  4 , Samsiyatu Abdulai  4 , Madina Ahmed  4 , Theophilus B Antwi  4 , Birago Boateng  4 , Miigbat P Libatin  4 , Alexander S Mensah  4 , Mary K Missah  4 , Richard V Duneeh  5 , Ashiya Haruna  4 , Stephany Adda  4 , Pagnaa G Abdul-Rauf  4 , Zacharia A Ofori  4 , George B Fosu  4 , Sandra Segnitome  4 , Isaac Adjei  4   6 , Emmanuel Appiah-Kubi  4 , Moses Banyeh  4 , Charles A Derigubah  2   7 , Muniru M Tanko  4 , Ejike F Chukwurah  2
Affiliations

Pro- and anti-inflammatory cytokines mediate the progression of severe anemia in malaria-infected children: A prospective study

Charles Nkansah et al. Immun Inflamm Dis. 2024 Sep.

Abstract

Background: Severe Plasmodium falciparum malarial anemia is still the principal cause of death in children in underdeveloped countries. An imbalance between proinflammatory and anti-inflammatory cytokines is associated with malaria progression. This study evaluated circulating levels of selected inflammatory cytokines among malaria-infected children in Ghana.

Methods: This case-control study was conducted at Tamale Teaching Hospital, Ghana. One hundred and twenty children with malaria and 60 controls, aged 12-144 months were selected from April to July, 2023 for the study. Malaria was diagnosed through microscopy, full blood count was measured using hematology analyzer, and cytokines were measured using enzyme-linked immunosorbent assay.

Results: Malaria-infected children had higher tumor necrosis factor alpha (TNF-α) (p < .001), interferon-gamma (IFN-ɣ) (p < .001), interleukin (IL)-1β (p < .001), IL-6 (p < .001), granulocyte macrophage-colony stimulating factor (GM-CSF) (p < .001), and IL-10 (p < .001) levels than controls. Participants with high parasitemia had raised TNF-α (p < .001), IFN-ɣ (p < .001), IL-1β (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but reduced IL-3 (p < .001) and TGF-β (p < .001) than those with low parasitemia. Severe malarial anemic children had elevated TNF-α (p < .001), IFN-ɣ (p < .001), IL-1β (p < .001), IL-6 (p < .001), GM-CSF (p < .001), and IL-10 (p < .001), but lower IL-3 (p < .001) and TGF-β (p < .001) than those with uncomplicated malaria.

Conclusion: Parasite density was the principal predictor of the cytokine levels, as parasitemia positively associated with IL-10, GM-CSF, IL-6, IL-1β, IFN-ɣ, and TNF-α, but negatively associated with IL-3 and TGF-β. Malaria is associated with enhanced secretion of pro- and anti-inflammatory cytokines in Ghanaian children. Inflammatory cytokines may be involved in the development of severe malarial anemia in children. However, IL-3 and TGF-β may offer protection against severe malarial anemia.

Keywords: P. falciparum; children; cytokines; malaria; severe malarial anemia.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Ghana Statistical Service . Malaria prevalence in children declines by a third in the past decade but the prevalence in rural areas is about three times as high compared to urban [Internet]. 2023. https://statsghana.gov.gh/gssmain/fileUpload/pressrelease/World
    1. Okyere B, Owusu‐Ofori A, Ansong D, et al. Point prevalence of asymptomatic plasmodium infection and the comparison of microscopy, rapid diagnostic test and nested PCR for the diagnosis of asymptomatic malaria among children under 5 years in Ghana. PLoS One. 2020;15(7 July):0232874. 10.1371/journal.pone.0232874 - DOI - PMC - PubMed
    1. Akosah‐Brempong G, Attah SK, Hinne IA, et al. Infection of plasmodium falciparum and helminths among school children in communities in Southern and Northern Ghana. BMC Infect Dis. 2021;21(1):1259. - PMC - PubMed
    1. Popa GL, Popa MI. Recent advances in understanding the inflammatory response in malaria: a review of the dual role of cytokines. J Immunol Res. 2021;2021:1‐9. - PMC - PubMed
    1. Weiland AS. Recent advances in imported malaria pathogenesis, diagnosis, and management. Current emergency and hospital medicine reports. 2023;11:49‐57. 10.1007/s40138-023-00264-5 - DOI - PMC - PubMed

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