دورية أكاديمية
Distinct Biomarker Profiles Distinguish Malawian Children with Malarial and Non-malarial Sepsis.
العنوان: | Distinct Biomarker Profiles Distinguish Malawian Children with Malarial and Non-malarial Sepsis. |
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المؤلفون: | Kortz TB; Department of Pediatrics, University of California, San Francisco, California.; Institute of Global Health Sciences, University of California, San Francisco, California., Nyirenda J; Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.; Department of Pathology, College of Medicine, University of Malawi, Blantyre, Malawi., Tembo D; Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi., Elfving K; Department of Infectious Diseases, Institution for Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Baltzell K; Department of Family Health Care Nursing, University of California, San Francisco, California.; Institute of Global Health Sciences, University of California, San Francisco, California., Bandawe G; Department of Biological Sciences, Malawi University of Science and Technology, Thyolo, Malawi., Rosenthal PJ; Department of Medicine, University of California, San Francisco, California., Macfarlane SB; Department of Epidemiology and Biostatistics, University of California, San Francisco, California., Mandala W; Department of Biological Sciences, Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo, Malawi.; Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi., Nyirenda TS; Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.; Department of Pathology, College of Medicine, University of Malawi, Blantyre, Malawi. |
المصدر: | The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2019 Dec; Vol. 101 (6), pp. 1424-1433. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: American Society of Tropical Medicine and Hygiene Country of Publication: United States NLM ID: 0370507 Publication Model: Print Cited Medium: Internet ISSN: 1476-1645 (Electronic) Linking ISSN: 00029637 NLM ISO Abbreviation: Am J Trop Med Hyg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Northbrook, IL : American Society of Tropical Medicine and Hygiene Original Publication: Baltimore. |
مواضيع طبية MeSH: | Malaria, Falciparum/*complications , Malaria, Falciparum/*diagnosis , Sepsis/*diagnosis , Sepsis/*parasitology, Biomarkers/blood ; Case-Control Studies ; Child, Preschool ; Cytokines/blood ; Female ; Fever/parasitology ; Humans ; Infant ; Malawi ; Male ; ROC Curve ; Retrospective Studies |
مستخلص: | Presently, it is difficult to accurately diagnose sepsis, a common cause of childhood death in sub-Saharan Africa, in malaria-endemic areas, given the clinical and pathophysiological overlap between malarial and non-malarial sepsis. Host biomarkers can distinguish sepsis from uncomplicated fever, but are often abnormal in malaria in the absence of sepsis. To identify biomarkers that predict sepsis in a malaria-endemic setting, we retrospectively analyzed data and sera from a case-control study of febrile Malawian children (aged 6-60 months) with and without malaria who presented to a community health center in Blantyre (January-August 2016). We characterized biomarkers for 29 children with uncomplicated malaria without sepsis, 25 without malaria or sepsis, 17 with malaria and sepsis, and 16 without malaria but with sepsis. Sepsis was defined using systemic inflammatory response criteria; biomarkers (interleukin-6 [IL-6], tumor necrosis factor receptor-1, interleukin-1 β [IL-1β], interleukin-10 [IL-10], von Willebrand factor antigen-2, intercellular adhesion molecule-1, and angiopoietin-2 [Ang-2]) were measured with multiplex magnetic bead assays. IL-6, IL-1β, and IL-10 were elevated, and Ang-2 was decreased in children with malaria compared with non-malarial fever. Children with non-malarial sepsis had greatly increased IL-1β compared with the other subgroups. IL-1β best predicted sepsis, with an area under the receiver operating characteristic (AUROC) of 0.71 (95% CI: 0.57-0.85); a combined biomarker-clinical characteristics model improved prediction (AUROC of 0.77, 95% CI: 0.67-0.85). We identified a distinct biomarker profile for non-malarial sepsis and developed a sepsis prediction model. Additional clinical and biological data are necessary to further explore sepsis pathophysiology in malaria-endemic regions. |
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معلومات مُعتمدة: | WT087537MA United Kingdom WT_ Wellcome Trust; 08754/Z/08/Z United Kingdom WT_ Wellcome Trust |
المشرفين على المادة: | 0 (Biomarkers) 0 (Cytokines) |
تواريخ الأحداث: | Date Created: 20191010 Date Completed: 20200324 Latest Revision: 20210110 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC6896879 |
DOI: | 10.4269/ajtmh.18-0635 |
PMID: | 31595873 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1476-1645 |
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DOI: | 10.4269/ajtmh.18-0635 |