Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable. In 2017, there were an estimated 219 million cases of malaria in 87 countries according to WHO. Treatment is paramount and the effectiveness and efficacy of antimalaria drugs has being the subject of several discuss. Recently, Dr. Okoli, C. A. of the Department of Paediatrics, University of Jos, Nigeria carried out a study to determine the responses of selected inflammatory, kidney and liver function markers in Serum of Nigerian Children with Severe Falciparum Malaria to treatment with artesunate/artemether-lumefantrine combination therapy.
“Malaria tolerance is a defence strategy that limits the damage caused by Plasmodium species irrespective of pathogen burden. The mechanisms responsible for this, responses of these mechanisms and their impact on organs to treatment have not been extensively studied. “ – Okoli, C. A.
In his study, serum levels of selected pro- and anti-inflammatory markers, liver and kidney function indices with leucocytes indices in 100 children (1-10 years) with severe falciparum malaria were determined before treatment, at 48 hours during treatment and 48 hours after treatment with WHO recommended dosage of artesunate/artemether-lumefantrine combination therapy using standard methods.
His results revealed that the serum levels of interleukin-12 (IL-12), interleukin-4 (IL-4), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), C-reactive protein (CRP), nitric oxide (NO), creatinine, albumin, total protein and conjugated bilirubin were not significantly changed at higher parasite densities before treatment. Only serum IL-4, CRP, total bilirubin, urea and creatinine levels and alanine aminotransferase activity were significantly reduced below the ranges of those with severe malaria.
His results suggested a self-protective feed-back control, indicating tolerance, which reduced the adverse effects of the disease on kidney and liver functions at higher parasite densities. This results also suggest serum IL-12, IL-4, TNF-α, IFN-γ, CRP and NO levels as immune-protective markers for tolerance and serum IL-4 level as an effective marker for disease severity and recovery from the disease in children with severe malaria