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“Background: Majority of malaria morbidity and mortality mostly arise in children younger than five years and this also happens to be the same period of time they become co-infected with Epstein –Barr virus (EBV). In areas of endemic malaria transmission, immunity to non-cerebral severe malaria is expected to be acquired after 1-2 infections with Plasmodium falciparum. Despite this immunity, 20% infected children die yearly due to severe malaria. Previous studies have shown that, dual infection of P. falciparum and EBV is the cause of endemic Burkitt’s lymphoma (eBL). However, there is scanty of information whether this same co-infection is the reason why malaria in children tends to be severe.
Aim: The aim was to study the association between co-infection of EBV with P. falciparum infection and malaria severity in children under five years of age.
Method: The study population comprised of children below 5 years of age who had been clinically diagnosed and confirmed to have malaria at the Divine Love and Nkenkensu Government hospitals. The study design was a cross sectional study and the convenient sampling technique was used to enrol 80 children with malaria. These children were then classified into two groups; severe malaria and non-severe malaria. ELISA was used to detect EBV specific immunoglobulins to EBNA-1 EBV antigen in the plasma of these children.
Results: In all, there were 49 (61.25%) children classified as having severe malaria and 31 (38.75%) children with non-severe malaria. Parasite density levels between the two groups showed a clear separation. WBC and parasite density also showed statistically significant differences (both ps< 0.05), compared to both RBC and Hb concentrations (both ps >0.05) between the two groups. Clinical histories of the two malaria groups for body temperature, duration of illness, fever and malaise, showed strong statistically
significant differences (all ps ≤ 0.0001). The overall seroprevalence of EBV in this study was 26.25%. The seroprevalence of EBNA-1 in children classified as severe malaria was 32.78%. No EBNA-1 IgG was found in children between 0-7 months. There was no significant association (p = 0.123) between severe malaria and EBV infection though children with EBV were more likely to develop severe malaria (Risk ratio 2.024, 95% CI 0.8249 to 4.9686, p = 0.1236)”.
Conclusion: The study determined that even though children with severe malaria had higher seroprevalence of EBV, this was not responsible for malaria severity since children with non- severe malaria also had EBV present in their blood plasma. Children with EBV were however, more likely to progress to severe malaria. |
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