Hematological Parameters and Key Cytokines in Patients With Uncomplicated Falciparum Malaria in Hodeidah, Yemen

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Abstract Immunity to malaria has a major role in controlling disease and pathogenesis with cytokine production being involved in almost each phase of the immune response. The present study aimed to assess hematological variables and to measure plasma levels of TNFα, IFNg and IL10, their ratios, and their relation to parasitemia among patients with uncomplicated falciparum malaria in Hodeidah, Yemen. Forty patients with uncomplicated P. falciparum monoinfection and 40 healthy age and sex matched controls were enrolled in the study. Parasitological diagnosis was confirmed, and parasite density estimated. Hematologic parameters, the presence of gametocytes, and plasma cytokine levels were determined. Results revealed lower Hb levels, RBC, lymphocyte and platelet counts and higher neutrophil and reticulocyte counts among patients compared to controls. TNFα, IFNg and IL10 were higher in patients than controls. A relatively higher IL10 production was demonstrated by the significantly lower TNFα/IL10 and IFNg/IL10 ratios in patients than controls. TNFα and IL10 correlated positively with parasite density. Reticulocyte count was higher and IFNg level was lower in the presence of gametocytes. Conclusively, uncomplicated falciparum malaria is associated with the ability to regulate the production of the pro-inflammatory and anti-inflammatory cytokines. This mediates parasite clearance while simultaneously avoiding severe pathology.

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