4.6 Article

High Plasma Levels of Neopterin Are Associated with Increased Mortality among Children with Severe Malaria in Benin

Journal

DIAGNOSTICS
Volume 13, Issue 3, Pages -

Publisher

MDPI
DOI: 10.3390/diagnostics13030528

Keywords

neopterin; severe malaria; cerebral malaria; anemia; Plasmodium falciparum; Benin

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This study evaluated the levels of plasma soluble neopterin in severe malaria patients and assessed its prognostic accuracy. The results showed that neopterin levels were higher in patients with severe malarial anemia and in patients who died from the disease. Plasma neopterin levels may serve as a potential biomarker for predicting fatality in severe falciparum malaria patients.
Among the barriers to accessing adequate treatment and high-level monitoring for malaria febrile patients is the lack of effective prognostic markers. Neopterin, which is a marker of monocyte/macrophage activation, was found have increased during severe malaria. In this study, we used quantitative ELISA in order to assess the levels of plasma soluble neopterin in 151 patients from a cohort of Beninese children with severe malaria. We evaluated the prognostic accuracy of this molecule in order to predict the outcome of the disease. Our results show that neopterin levels were not significantly different between patients with different forms of severe malaria, including severe non-cerebral malaria (SNCM) and cerebral malaria (CM). However, the levels of this molecule were found to be higher in patients with severe malarial anemia (SMA) among both CM and SNCM cases (p-value = 0.02). Additionally, the levels of this molecule were found to be higher in patients who died from these pathologies compared to those who survived among the two clinical groups (p-value < 0.0001) and within the same group (p-value < 0.0001 for the CM group, p-value = 0.0046 for the SNCM group). The AUC-ROC for fatality among all the severe cases was 0.77 with a 95%CI of (0.69-0.85). These results suggest that plasma neopterin levels constitute a potential biomarker for predicting fatality among severe falciparum malaria patients.

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