| Erythropoietin levels are not independently associated with malaria-attributable severe disease in Mozambican children. | |
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MedLine Citation:
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PMID: 21912616 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Severe malaria is difficult to differentiate from other forms of malaria or other infections with similar symptoms. Any parameter associated to malaria-attributable severe disease could help to improve severe malaria diagnosis. METHODOLOGY: This study assessed the relation between erythropoietin (EPO) and malaria-attributable severe disease in an area of Mozambique with moderate malaria transmission. 211 children <5 years, recruited at Manhiça District Hospital or in the surrounding villages, were included in one of the following groups: severe malaria (SM, n = 44), hospital malaria without severity (HM, n = 49), uncomplicated malaria (UM, n = 47), invasive bacterial infection without malaria parasites (IBI, n = 39) and healthy community controls (C, n = 32). Malaria was diagnosed by microscopy and IBI by blood/cerebrospinal fluid culture. PRINCIPAL FINDINGS: Mean EPO concentration in the control group was 20.95 U/l (SD = 2.96 U/l). Values in this group were lower when compared to each of the clinical groups (p = 0.026 C versus UM, p<0.001 C vs HM, p<0.001 C vs SM and p<0.001 C vs IBI). In the 3 malaria groups, values increased with severity [mean = 40.82 U/l (SD = 4.07 U/l), 125.91 U/l (SD = 4.99U/l) and 320.87 U/l (SD = 5.91U/l) for UM, HM and SM, respectively, p<0.001]. The IBI group [mean = 101.75 U/l (SD = 4.12 U/l)] presented lower values than the SM one (p = 0.002). In spite of the differences, values overlapped between study groups and EPO levels were only associated to hemoglobin. Hemoglobin means of the clinical groups were 93.98 g/dl (SD = 14.77 g/dl) for UM, 75.96 g/dl (SD = 16.48 g/dl) for HM, 64.34 g/dl (SD = 22.99 g/dl) for SM and 75.67 g/dl (SD = 16.58 g/dl) for IBI. CONCLUSIONS: Although EPO levels increase according to malaria severity and are higher in severe malaria than in bacteremia, the utility of EPO to distinguish malaria-attributable severe disease is limited due to the overlap of values between the study groups and the main role of hemoglobin in the expression of EPO. |
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Authors:
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Núria Díez-Padrisa; Ruth Aguilar; Sonia Machevo; Luis Morais; Tacilta Nhampossa; Cristina O'Callaghan-Gordo; Delino Nhalungo; Clara Menéndez; Anna Roca; Pedro L Alonso; Quique Bassat |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-08-30 |
Journal Detail:
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Title: PloS one Volume: 6 ISSN: 1932-6203 ISO Abbreviation: PLoS ONE Publication Date: 2011 |
Date Detail:
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Created Date: 2011-09-13 Completed Date: 2011-12-23 Revised Date: 2012-04-26 |
Medline Journal Info:
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Nlm Unique ID: 101285081 Medline TA: PLoS One Country: United States |
Other Details:
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Languages: eng Pagination: e24090 Citation Subset: IM |
Affiliation:
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Centre de Recerca en Salut Internacional de Barcelona, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bacteremia
/
diagnosis,
metabolism Bilirubin / blood Child, Preschool Diagnosis, Differential Erythropoietin / metabolism* Female Hemoglobins / metabolism Hemolysis Humans Infant L-Lactate Dehydrogenase / blood Malaria / blood, diagnosis, metabolism*, transmission Male Mozambique |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins; 11096-26-7/Erythropoietin; 635-65-4/Bilirubin; EC 1.1.1.27/L-Lactate Dehydrogenase |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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