Okoli C. A*, Igunnu A, Oguche S, Malomo S. O
Background: Monitoring of therapeutic response, prompt and accurate diagnosis are important for effective treatment and management of children with severe malaria. The serum levels of zinc, copper, iron, magnesium, calcium, inorganic phosphate, sodium, potassium, chloride, creatinine, urea and Uric Acid (UA) were determined using standard methods in 100 children (1 years-10 years) with severe malaria before treatment (day 0), 48 hours of treatment (day 2) and 48 hours after treatment (day 7) according to WHO recommended dosage of Artesunate/ Artemether-Lumefantrine Combination Therapy (AALCT), and 200 clinically healthy children.
Decreased serum Na, and elevated creatinine and urea levels on admission normalised 24 hours after treatment; indicating a fast response. Elevated serum UA concentration showed the highest malaria diagnostic potential (96.5% sensitivity, 83.0% specificity, 7.78% negative predictive value, 91.10% positive predictive value, and 134.61 odds ratio, 0.932 area under the curve at 95% confidence limit).
Conclusion: The results of this study indicated that decreased serum Na, elevated creatinine and urea levels on admission showed fast response to treatment with AALCT in children with severe Falciparum malaria and elevated serum UA level showed a relatively high Falciparum malaria diagnostic potential. Therefore, these can be used as adjuncts to conventional methods.