Prognostic value of Serum C-Reactive Protein in Malaria

Abstract

Introduction: C-Reactive protein is known as a marker of morbidity and mortality in malaria. It correlates closely with other complications in malaria and can be used to predict severity. Thus, measurement of CRP can be useful in understanding the pathogenesis of severe malaria. However, studies regarding CRP in malaria are very rare from India.
Aims and objectives: The present study aimed to study CRP levels in patients with malarial infection and to find out the usefulness of CRP in assessment of disease severity.
Material and Methods: The study population consisted of 50 patients with malarial infection, of them 29 were Plasmodium falciparum, 21 were P. vivax-infected and no patient found with dual infection in our study. Out of 50 patients, 17 patients required admission for various reasons and of them 5 patients died. Serum C-reactive protein concentrations were measured in all the patients. Percentage parasitemia, platelet count and Liver function tests were measured on the day of admission. Statistical tests included were Students t-test, chi-square test and Pearson correlation coefficient.
Results: Serum C-reactive protein concentration was significantly elevated in all the malaria patients and it was significantly higher (P 0.01) in Plasmodium falciparum (28.81 10.91 mg/L) as compared to P. Vivax malaria (15.91 8.73 mg/L ). Admitted patients had higher CRP levels (47.80 12.73 mg/L) compared to patients treated on OPD basis (24.14 12.17 mg/L) (P 0.0001). Also CRP levels were higher in patients with multiple complications and in the patients who died compared to survivors. A significant positive correlation was found between serum CRP and percentage parasitemia, serum bilirubin, serum alanine aminotransferase and serum aspartate aminotransferase in P. falciparum infected patients but not in P. Vivax.
Conclusion: There is significant increase in C-reactive protein in malaria infected patients and can be considered a cost - effective and reliable tool in assessment of prognosis in malaria.