Evaluation of Renal and Hepatic Dysfunction among Children Less than Five Years with Malaria in Jasikan District, Oti Region- Ghana

Abstract

Background Malaria continues to be a menace in many parts of the world, contributing to high morbidity and mortality especially in developing countries. Irrespective of the immense contributions made to control malaria infection rates, the infection perpetually plagues numerous lives in sub-Saharan Africa. Malaria infection has also been implicated in renal and hepatic dysfunction. The renal dysfunction typifies an increase of urea and creatinine levels in serum whiles the hepatic dysfunction signifies an increase in liver transaminases. Despite the linkage of malaria with kidney and liver dysfunction, their precise interrelationship or interaction especially in children has not been fully elucidated. General aim This study aimed to evaluate the effects of malaria infection on renal and hepatic function among children less than five years in Jasikan, Oti- region, Ghana. Methodology A cross-sectional study involving 400 children aged 6-59 months. Participants were tested for malaria parasites using microscopy examination on blood films. Subjects that were positive for the parasite were further categorized into two groups based on the quantification of parasites per micro liter (μl) of blood: children with mild infection (parasitaemia less than 100,000 parasites per microlitre of blood) and those with severe infection (parasitaemia more than 100,000 parasites per microlitre of blood). Malaria negative samples were screened and served as controls. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin and bilirubin concentrations were measured to evaluate liver dysfunction whilst serum urea and creatinine were used to assess kidney dysfunction among all participants. Results Results show significant difference (p<0.05) in serum creatinine, urea, AST and ALT levels of children with positive parasitaemia compared with the control group. Among the positive parasitaemia subjects, urea, creatinine, AST and ALT levels were also statistically different (p<0.05) for severe versus mild groups. Serum protein and albumin levels were significantly higher (p<0.05) in the control group relative to the case group. The serum total and direct bilirubin levels were significantly higher (p< 0.05) in the severe infected group relative to the mild and control groups. Conclusion This study observed that malaria infection has a significant effect on renal and hepatic functions with increasing concentrations paralleling severity of parasitaemia.