Introduction
Materials and methods
Study design and participants
Characteristicsa | HIV + (n = 70) | HIV− (n = 61) | ||
---|---|---|---|---|
Uncomplicated (n = 13) | Severe (n = 57) | Uncomplicated (n = 33) | Severe (n = 28) | |
Age, years | 38 (26–56) | 40 (20–65) | 39 (18–79) | 41 (20–65) |
Female, sex | 6 (46%) | 29 (51%) | 13 (39%) | 12 (43%) |
Haemoglobin, g/dL | 10.8 (7.7–13.8) | 9.0 (2.5–15.7) | 11.5 (5.6–15.7) | 10.8 (3.2–17.0) |
Platelets, × 109/L | 97 (23–205) | 92 (8–330) | 124 (21–324) | 124 (11–452) |
Se-Creatinine, µmol/L | 101 (71–146) | 257 (62–1529) | 108 (57–203) | 149 (72–357) |
Malaria Rapid Test pos | 12 (92%) | 46 (81%) | 32 (97%) | 20 (71%) |
Microscopy pos | 10 (77%) | 46 (81%) | 28 (85%) | 22 (79%) |
Qual. blood cell mal. PCR pos | 13 (100%) | 56 (98%)b | 32 (97%) | 27 (96%) |
Quant. plasma mal. PCR pos | 8 (62%) | 41 (72%)2) | 22 (67%) | 22 (79%) |
Plasma P.falciparum DNA conc.c | ||||
Mean genom./µL | 82 (6–404) | 1063 (6–17050) | 125 (6–1210) | 3965 (6–106500) |
Median genom./µLd | 26 (6–142) | 48 (6–379) | 11 (6–68) | 43 (10–224) |
Respiratory rate | 21 (18–28) | 26 (16–44) | 20 (12–28) | 25 (16–68) |
BP systolic, mmHg | 122 (100–170) | 113 (80–170) | 125 (90–240) | 119 (70–160) |
Bleeding disturbance/haemolysis | 0 | 9 | 0 | 1 |
Died | 0 | 9 | 0 | 1 |
Procedures
PCR assessing plasmodium DNA extracted from the blood cell fraction
Quantitative PCR assessing P. falciparum DNA directly from plasma
Statistics
Results
Previous study: patient population
Present study: quantitative malaria PCR in plasma
Plasma parasitemia as assessed by qPCR in relation to disease severity and HIV co-infection
n | Plasma-PCR pos | Plasma-PCR neg | pa |
---|---|---|---|
63 | 22 | ||
Severe anaemiab | 5 (3/59) | 45 (10/22) | < 0.001 |
Plateletsc | 84 (8–319) | 151 (17–452) | 0.002 |
Severe renal failured | 24 (13/54) | 32 (6/19) | 0.52 |
Severe respiratory failuree | 25 (16/63) | 27 (6/22) | 0.86 |
Hypoglycaemiaf | 9 (5/54) | 0 (0/19) | 0.17 |
Hypotensiong | 2 (1/54) | 0 (0/21) | 0.53 |
Coagulation disturbanceh | 8 (5/63) | 23 (5/22) | 0.064 |
Cerebral malariai | 37 (23/63) | 27 (6/22) | 0.43 |
Hyperparasitemiaj | 76 (45/59) | 21 (4/19) | < 0.001 |
Liver failurek | 25 (16/63) | 0 (0/22) | 0.009 |
Fatalities | 13 (8/63) | 10 (2/21) | 0.70 |
Characteristics | Unadjusted | Adjusted | ||
---|---|---|---|---|
OR (95% CI) | p valuea | OR (95% CI) | p value | |
Age | 1.01 (0.99, 1.04) | 0.40 | 1.01 (0.98, 1.04) | 0.66 |
Sex | 0.76 (0.37, 1.56) | 0.45 | 0.72 (0.31, 1.67) | 0.45 |
HIV | 5.17 (2.36, 11.33) | < 0.001 | 5.37 (2.37, 12.16) | < 0.001 |
Log qPCR | 1.41 (1.02, 1.96) | 0.037 | 1.43 (0.99, 2.07) | 0.055 |