TITLE:
Determination of Effect of Home-Based Oral Chloroquine Treatment on Haematological Indices of P. falciparum Malaria in Children under 5 Years in Jos Metropolis
AUTHORS:
Segun Afolabi Olomu, Ubom Gregory Abraham, Garba Ibrahim Hassan
KEYWORDS:
Malaria, Chloroquine, Children, Hospital, Treatment
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.8 No.2,
June
13,
2018
ABSTRACT: Background: The incidence of P. falciparum malaria is characterized by high rates of morbidity and mortality in under 5 children; a trend reportedly prevalent in tropical and subtropical countries including Nigeria, and recently observed in Jos metropolis, has to date defied all constructive, preventive and drug therapy intervention measures and consequently continues to constitute a serious public health problem in this most vulnerable group. Objective: The aim of this study was to determine certain haematological indicators of malaria parasite infection; their role in the clinical manifestation of P. falciparum malaria and effect of first line oral chloroquine treatment in children under 5 years attending Jos University Teaching hospital and OLA Hospital in Jos metropolis. Method: This is a cross-sectional study of 93 malaria and non-malaria children, age 1 - 59 months attending Jos University Teaching Hospital (JUTH), Jos and OLA hospital, Jos, North Central Nigeria. Malaria diagnosis was carried out using microscopical examination of Leishman’s stained thick and thin blood films and complete blood count was done using Beckman Coulter Analyzer. Results: The mean percentage lymphocyte value of chloroquine treated children (39.28% ± 7.45%) was significantly lower than the control (66.38% ± 2.27%). The mean granulocyte value of chloroquine treated children (51.07% ± 6.40%) was significantly higher than the control (26.69% ± 2.43%). Red Blood Cell (RBC) counts (4.01 ± 0.21 × 106/μL), Haemoglobin concentration (9.60 ± 0.51 g/dl) and Haematocrit (30.97% ± 1.43%) of chloroquine treated children were significantly higher than corresponding values in untreated malarious children, but not significantly different from values obtained in non-malaria control children. The RBC counts (2.92 ± 0.39 × 106/μL), Haemoglobin concentration (7.23 ± 1.01 g/dl) and Haematocrit (23.70% ± 3.37%) obtained for untreated malarious children were significantly lower than corresponding values in the non-malarious control children. Conclusion: The pattern of the results obtained in this study suggests that home-based, first-line oral chloroquine treatment 24 hours prior hospital admission decreases the lymphocytes production and elevated production of granulocytes with attendant consequences on their biological functions. The chloroquine treatment seems to protect the red blood cells against the destructive effect of malaria. The haemoglobin concentration of 7.23 ± 1.01 g/dl obtained in untreated malaria children when combined with results of red blood cells; differential analysis indicates a mild, normocytic, normochromic anaemia due to haemolysis. This study demonstrates the beneficial effects of first aid, home-based oral chloroquine use. Rational use of chloroquine needs to be re-evaluated and encouraged in this group of children.