The Pattern of Parasite Density, Plasma Total Bile Acids and Lactate Dehydrogenase in Plasmodium Infected Patients in Rural Community

Background to the study: Pathophysiology of Plasmodium (vivax, ovale, falciparum and malariae) infection involves liver. Liver dysfunction and destruction of tissues could be indicated by the plasma level of Total Bile Acid (TBA) and Lactate Dehydrogenase (LDH). Aim and Objective: This work was designed to evaluate the pattern of parasite density, plasma total bile acids, and Lactate dehydrogenase in Plasmodium infected patients in rural community. Materials and Methods: The study was carried out in Kishi, the Headquarter of Irepo Local government area of Oyo state Nigeria. Seven hundred and nine (709) subjects (Female: n=403: male: n=306) aged 5 to 68 years were tested for Plasmodium infection using Giemsathick film technique. The overall prevalence of Plasmodium infection among the seven hundred and nine subjects screened was found to be 29.1% (206) including 12.97% (92) HIV, HBsAg and anti-HCV seronagative patients and 16.1% (114) HIV, HBsAg or anti-HCV seropositive patients. Ninety two (92 (12.97%)) that were HIV, HBsAg and anti-HCV seronagative(female-58 (63.0%); male-34 (37%)) were recruited out of 206 (29.1%) that were found to be infected with plasmodium spp for the study. None of the subject was jaundiced as at the time of sample collection. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were carried out by Enzyme Linked Immunozorbent Assay (ELIZA). HIV screening and confirmation were carried out by immuno-chromatographic and Immunobloting (Western blot) assays respectively. Fasting Plasma Total Bile Acids (TBA) and Lactate Dehydrogenase (LDH) were analyzed in the patients biochemically by spectrophotometry. Result: The result obtained showed an overall prevalence of Plasmodium infection as 29.1% (206) (female: 107 (52%); male: 99 (48%)) including 12.97% (92) (Female: 58 (63.0%) Male: 34 (37%)) that were HIV, HBsAg and anti-HCV seronagative and 16.1% (114) (Female: 61 (53.5%); Male: 53 (46.5%)) were co-infected with at least one of HIV, HBV or HCV. The plasmodium infected subjects were grouped into three based on the parasite density such as: patients with parasite density of 50-499; 500-999 and ≥1000. The mean value of the parasite density of each group was correlated with the plasma level of LDH and TBA. In all groups there was a strong positive correlation(R=1; R2 =1) between the plasma TBA, LDH and plasmodium parasite density. The pattern of parasite density obtained in the rural community studied include 45.7% had a mean parasite density of 282±12.0; 43.5% (853±31.0) and 10.9% (1130±61.0). There was also a statistical significant increase in the mean value of LDH and TBA with increase in parasite density with p<0.05. Conclusion: This work showed an overall prevalence of 29.1% (206) plasmodium infection including 16.1% (114) of the patients co-infected with at least one of HIV, HBV or HCV. The plasma level of LDH and TBA was also found to be positively correlated and directly proportional to the parasite density. Evaluation of these parameters is therefore recommended for effective control