Clinical utilization of Chondroitin Sulphate-A to determine the susceptibility of pregnant women to malaria
Loading...
Date
AUGUST, 2015
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
People living in areas with stable transmission of Plasmodium falciparum parasites
acquire protective immunity to malaria following multiple disease episodes.
Immunity acquired this way is mediated by IgG with specificity for parasite-encoded, clonally variant surface antigens (VSA) on the surface of infected
erythrocytes (IEs). However, women in endemic areas become susceptible to P.
falciparum infection during pregnancy, particularly for the first time, regardless of
acquired protective immunity. Aggregation of erythrocytes infected by P.
falciparum in the intervillous spaces of the placenta using chondroitin sulphate A
(CSA) as the dominant placental adhesion receptor has been identified.
Chondroitin sulfate A is a sulfated glycosaminoglycan (GAG) composed of a chain
of alternating sugars. It is usually found attached to proteins as part of a
proteoglycan. This study sought to investigate the role of chondroitin sulphate A
in malaria susceptibility in pregnant women.
A total of 160 clients attending two selected health facilities, namely Kaneshie
Polyclinic and Our Lady of Grace Hospital, were recruited. They were stratified
into three groups: Pregnant women with malaria (n=80), non-pregnant women
with malaria (n=40) and pregnant women without malaria (n=40). Full blood count
(FBC), malaria RDT, thick film for malaria parasites and ELISA for chondroitin
sulphate-A concentration were conducted for each volunteer. The mean
haemoglobin count in pregnant women with malaria was 9.6 ± 1.4 g/dl and that of
non-pregnant women with malaria was 10.3 ± 1.6 g/dL and the pregnant women
without malaria was 11.5 ± 1.1 g/dL. The median CSA concentration in non-pregnant women with malaria was 2.24 ng/mL; that of pregnant women with
malaria was 50.76 ng/mL, and pregnant women without malaria was 44.94
ng/mL. There were significant differences between non-pregnant women with
malaria and pregnant women with malaria (P=0.0001) and also between non-pregnant with malaria and pregnant women with no malaria (P=0.0001) but no
difference between pregnant women with malaria and pregnant women without
malaria (P=0.084). Haemoglobin and haematocrit concentrations were significantly
associated with malaria infection. The parasite count in pregnant women with
malaria compared with that in non-pregnant women with malaria was
significantly lower (P=0.0001). Malaria infection was associated with reduction in
haemoglobin concentration, which worsened when pregnancy was present. In
conclusion, CSA was elicited in pregnant women but had inverse correlation with
peripheral malaria parasitaemia.
Description
A thesis submitted in fulfillment of the requirements for the degree of Master of Philosophy in the Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences.