Clinical relevance of different biomarkers in imported plasmodium falciparum malaria in adults: a case control study
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Clinical relevance of different biomarkers in imported plasmodium falciparum malaria in adults: a case control study. / Stauga, Sabine; Hahn, Andreas; Brattig, Norbert W; Fischer-Herr, Johanna; Baldus, Stephan; Burchard, Gerd D; Cramer, Jakob P.
in: MALARIA J, Jahrgang 12, 01.01.2013, S. 246.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Clinical relevance of different biomarkers in imported plasmodium falciparum malaria in adults: a case control study
AU - Stauga, Sabine
AU - Hahn, Andreas
AU - Brattig, Norbert W
AU - Fischer-Herr, Johanna
AU - Baldus, Stephan
AU - Burchard, Gerd D
AU - Cramer, Jakob P
PY - 2013/1/1
Y1 - 2013/1/1
N2 - BACKGROUND: For rapid initiation of anti-malarial treatment and prevention of complications, early diagnosis and risk stratification is important in patients with Plasmodium falciparum malaria. Routine laboratory values do not correlate well with disease severity. The aim of this study was to determine the diagnostic and prognostic value of several biomarkers related to inflammation; endothelial and cardiac dysfunction; coagulation, and haemolysis in imported P. falciparum malaria.METHODS: In a prospective case-control study, 79 adult travellers with both uncomplicated and complicated P. falciparum malaria were included between 2007 and 2011. Forty-one healthy subjects were included as controls. Blood samples were obtained within 24 hours after first consultation to assess routine laboratory values as well as markers related to inflammation (PAPP-A, copeptin, CRP), endothelial activation (MPO, elastase-2, endothelin-1, sICAM-1, sVCAM-1), cardiac function (NT-proBNP, MR-proANP), coagulation (fibrinogen, D-dimers, platelet count), and haemolysis (LDH). Prognostic performance was assessed using the receiver operating characteristic curve (area under the curve = AUROC).RESULTS: Twelve (15.2%) patients had severe P. falciparum malaria. In the patient group, significant thrombocytopaenia was found, all other markers but PAPP-A were significantly elevated. Diagnostic performance was best for CRP with an AUROC of 1.00, followed by MPO (0.99), D-dimers (0.98), elastase-2 (0.98), and sICAM-1 (0.98). Biomarker levels did not correlate well with disease severity.CONCLUSION: The combination of travel history, fever prior to blood sampling, and CRP serum levels above or below 10.8 mg/l upon hospital admission, best discriminated between malaria patients and control persons. None of the biomarkers studied predicted the presence or the development of malaria complications, neither at the time of admission, nor during hospitalization.
AB - BACKGROUND: For rapid initiation of anti-malarial treatment and prevention of complications, early diagnosis and risk stratification is important in patients with Plasmodium falciparum malaria. Routine laboratory values do not correlate well with disease severity. The aim of this study was to determine the diagnostic and prognostic value of several biomarkers related to inflammation; endothelial and cardiac dysfunction; coagulation, and haemolysis in imported P. falciparum malaria.METHODS: In a prospective case-control study, 79 adult travellers with both uncomplicated and complicated P. falciparum malaria were included between 2007 and 2011. Forty-one healthy subjects were included as controls. Blood samples were obtained within 24 hours after first consultation to assess routine laboratory values as well as markers related to inflammation (PAPP-A, copeptin, CRP), endothelial activation (MPO, elastase-2, endothelin-1, sICAM-1, sVCAM-1), cardiac function (NT-proBNP, MR-proANP), coagulation (fibrinogen, D-dimers, platelet count), and haemolysis (LDH). Prognostic performance was assessed using the receiver operating characteristic curve (area under the curve = AUROC).RESULTS: Twelve (15.2%) patients had severe P. falciparum malaria. In the patient group, significant thrombocytopaenia was found, all other markers but PAPP-A were significantly elevated. Diagnostic performance was best for CRP with an AUROC of 1.00, followed by MPO (0.99), D-dimers (0.98), elastase-2 (0.98), and sICAM-1 (0.98). Biomarker levels did not correlate well with disease severity.CONCLUSION: The combination of travel history, fever prior to blood sampling, and CRP serum levels above or below 10.8 mg/l upon hospital admission, best discriminated between malaria patients and control persons. None of the biomarkers studied predicted the presence or the development of malaria complications, neither at the time of admission, nor during hospitalization.
KW - Adolescent
KW - Adult
KW - Aged
KW - Biological Markers
KW - Blood Chemical Analysis
KW - Case-Control Studies
KW - Clinical Medicine
KW - Early Diagnosis
KW - Female
KW - Human Migration
KW - Humans
KW - Malaria, Falciparum
KW - Male
KW - Medical History Taking
KW - Middle Aged
KW - Prognosis
KW - Prospective Studies
KW - Travel
KW - Young Adult
U2 - 10.1186/1475-2875-12-246
DO - 10.1186/1475-2875-12-246
M3 - SCORING: Journal article
C2 - 23866258
VL - 12
SP - 246
JO - MALARIA J
JF - MALARIA J
SN - 1475-2875
ER -