Measuring a malaria protein, HRP2 can predict likelihood of cerebral malaria: Study
A simple blood test could tell physicians whether a child with malaria will progress to the life-threatening form of the parasitic disease, cerebral malaria, according to a study by Michigan State University and Malawi researchers.
Image-CDC/ James Gathany
Karl Seydel, MSU assistant professor of osteopathic medical specialties and colleagues say testing patients’ blood for HRP2 – a protein produced by the malaria parasite, and found it to be an accurate predictor of how the disease progressed among children at Queen Elizabeth Central Hospital in Blantyre, Malawi.
The findings are published in the Journal of Infectious Diseases.
Some children with uncomplicated malaria (UM) progress to cerebral malaria (CM) despite appropriate treatment; identifying them in advance might improve their care. The objective of this study was to determine if plasma concentrations of a malaria protein, HRP2 (histidine-rich-protein-2) would serve this purpose.
Cases and controls were children presenting with UM; the cases (n=25) developed CM, and the controls (n=125) did not. Mean plasma HRP2 concentrations were significantly higher in the cases, and an HRP2 cut-off was identified which could predict disease progression (sensitivity and specificity both=88%). Quantitative measurements of HRP2 may be a useful screening tool.
MSU researchers say the screening test could be a game-changer in resource-limited rural health clinics where workers see hundreds of children with malaria each day and must decide which patients can be sent home with oral drugs and which need to be taken to hospitals for more comprehensive care.
Image/CIA
“Rural health workers have to make these decisions with very little objective data, and the consequences of an inappropriate decision are huge,” according to Dr. Seydel. “Children who progress to cerebral malaria have a 20 percent mortality rate, or even higher if they don’t get the right treatment early in the disease process.”
“We found that if HRP2 levels are low, clinicians can be more than 98 percent sure the child will not progress to cerebral malaria,” Seydel said. “That would give them the confidence to merely prescribe oral drugs and send the child home.”
Testing for HRP2 would be a huge advantage in Africa where the vast majority of childhood malaria deaths occur.
However, the screening tool is still very expensive and not well suited for rural setting, but Seydel says a less expensive and more portable version is being developed.
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