[en] Context: Pathogenesis of acute massive intravascular
hemolysis in Blackwater fever is very complex. Mostly,
Malaria immunity deficiency in expatriates, Quinine and
Plasmodium are incriminated. The possible role of malaria
IgG1 antibodies in BWF is not fully elucidated.
Objectives: This study aimed to determine the profile of
malaria IgG1 for malaria crude antigen in children
developing blackwater fever compared to patients with
uncomplicated malaria
Methods: This case-control study was conducted in 4
medical institutions across Kinshasa. Cases were patients
with Blackwater fever (BWF) whereas controls had
uncomplicated Plasmodium falciparum malaria (UM). For
each case, 2 controls were recruited and were matched for
age, sex and the area of residence. Malaria IgG1 were
assessed by standard ELISA and absorbance measured in an
automated plate reader.
Results: The majority of BWF cases (81.4%) were above 5
years old while only 18.6% were aged below 5 (OR: 1.33;
0.53-3.32). The level of malaria IgG antibodies in BWF
children were significantly higher compared to
uncomplicated malaria (p=0.002). Quinine was used by
95.3% of the BWF cases ([OR: 50.19 (10.75-234.42)]
p<0.001) versus in uncomplicated malaria. There was no linear correlation between the age of patients and the
logarithm of antibodies. R2 is totally null (p=0.335).
Conclusion: Malaria IgG1 antibodies is significantly elevated
in children with BWF and could trigger the occurrence of
BWF. The absence of correlation with age suggests that BWF
could not be age dependent.
Disciplines :
Laboratory medicine & medical technology Immunology & infectious disease
