Evaluation of blood cell count parameters as predictors of treatment failure of malaria in Angola: An observational study

Sacomboio, Euclides N. M., dos Santos Sebastião, Cruz, da Costa Salvador, Silvana T., João, Joaquim A., Bapolo, Daisy V. S., Francisco, Ngiambudulu M., Morais, Joana and Valentim, Eduardo E. (2022) Evaluation of blood cell count parameters as predictors of treatment failure of malaria in Angola: An observational study. PLOS ONE, 17 (5). e0267671. ISSN 1932-6203

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Official URL: https://doi.org/10.1371/journal.pone.0267671


Background- Despite the guidelines provided by the World Health Organization for the treatment of malaria, treatment failure occurs in many hospitalized patients. Objective- Evaluate whether blood cell count parameters may serve as predictors for malaria treatment. Methodology- A cross-sectional study with a quantitative approach. Results- Of the 219 patients, 21.5% showed failure to antimalarial treatment, Patient with 21 and 40 years (72.6%), male (53.4%), from peri-urban area (47.5%), with high parasitemia (59.8%), treated with Arthemeter (90.9%) and the mortality were 5.9%. Significant associations were observed between occupation, level of parasitemia and outcome with resistance to antimalarial treatment (p<0.05). Patients with normal Hb [OR: 0.75 (95% CI: 0.39–1.44), p = 0.393], RBC [OR: 0.83 (95% CI: 0.40–1.72), p = 0.632], RDW [OR: 0.54 (95% CI: 0.27–1.09), p = 0.088], MCV [OR: 0.61 (95% CI: 0.28–1.31), p = 0.204] were less likely to have malaria treatment failures after artemisinin-based therapy failure. In contrast, those with normal values of segmented neutrophils [OR: 0.32 (95% CI: 0.11–0.96), p = 0.042] and lymphocyte counts [OR: 0.24 (95% CI: 0.05–1.04), p = 0.055]. We also found that patients with significant low levels of Hct [OR: 0.31 (95% CI: 0.15–0.64) p = 0.002], and high leukocytes [OR: 8.88 (95% CI: 2.02–37.2), p = 0.004] and normal platelet values [OR: 1.42 (95% CI: 0.73–2.95), p = 0.280] demonstrated high probability of treatment failure. Conclusion- The importance of blood cell count parameters in monitoring malaria therapy necessitates the urgent need to re-evaluate Artemether-based therapy. Future studies involving more participants in different settings are needed to provide further evidence.

Item Type: Journal Article
Keywords: Antimalarials, Malaria, Antimicrobial resistance, Blood counts, Parasitemia, Drug therapy, Red blood cells, White blood cells
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 30 May 2022 10:33
Last Modified: 31 May 2022 16:18
URI: https://arro.anglia.ac.uk/id/eprint/707642

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