Liver Enzymes and Lipid Profile of Malaria Patients Before and After Antimalarial Drug Treatment at Dembia Primary Hospital and Teda Health Center, Northwest, Ethiopia

Abstract

Background: Infection with malaria in humans involves liver cell destruction, which alters the levels of liver enzymes and lipid profiles. A number of studies have been conducted to address the impact of malaria on liver enzymes and lipid profiles but no studies were addressed after antimalarial treatment in Ethiopia. This study is intended to fill this gap. Methods: An observational cohort study was conducted at Dembia Primary Hospital and Teda Health Center, from June to August 2020. Eighty eight malaria infected study participants were recruited using random sampling techniques. Sociodemographic data, capillary and venous blood samples were collected. Assessment of liver enzymes and lipid profiles was done using Beckman Coulter DC-700 clinical chemistry analyzer. Data were entered using Epi-data and exported to SPSS version 20 for analysis. One way ANOVA, independent t-test, and paired t-test were used to compare the mean liver enzymes and lipid profile. p-value<0.05 was considered statistically significant. Results: Before anti-malaria treatment, among 88 study participants, elevated AST (87.5%), ALT (12.5%), ALP (43.2%), and TG (17.2%) and lower HDL (87.5%) and normal LDL and TC were observed. After treatment, 100% AST, ALT, HDL, and LDL and 92% ALP, 94.3% TC, and 86.4% TG levels were in the normal range. The mean level of AST and ALT increased while HDL decreased from low to higher density parasitaemia. Mean level of AST was significantly lower while ALT did not alter. HDL, LDL, and TC level were increased but statistically were insignificant (P>0.05). Conclusion: Malaria could be responsible for increased liver enzymes and certain lipids while decreasing some lipid profiles. After anti-malaria treatment, these parameters were reversed to normal from 86.4% to 100%. Hence, prompt treatment is important to improve liver enzymes and lipid profile impairment during malaria infection.

Biochemical characteristics of patients with imported malaria

“…In contrast to an increase in the liver enzyme that was observed in previous studies, we observed no elevation of liver enzyme in this study ( Viriyavejakul et al., 2014 ; Rocha et al., 2015 ; Dinkar et al., 2020 ; Megabiaw et al., 2022 ); however, abnormalities in the ratio of aspartate aminotransferase to alanine aminotransferase were observed in 43% of the patients, and higher ratios of aspartate aminotransferase to alanine aminotransferase were significantly associated with malaria parasitemia. The liver enzyme profiles are distinct from prior studies ( Viriyavejakul et al., 2014 ; Dinkar et al., 2020 ; Megabiaw et al., 2022 ). Based on the findings on the clinical history of prior prophylactic administration, we speculate that adherence to prophylactic treatment with antimalarial medications before and after infection has a hepatoprotective role.…”

“…Many of these molecules promote vasculature occlusion for inducing inflammation and endothelial cell activation and induce acute-phase responses to prevent the spread of malaria. Routine laboratory results indicate liver and kidney dysfunction ( Nieman et al., 2009 ; Nantakomol et al., 2011 ; Mita-Mendoza et al., 2013 ; Mangal et al., 2017 ; Cheaveau et al., 2019; Dinkar et al., 2020 ; Khrapunov et al., 2021 ; Tona Lutete et al., 2021 ; Megabiaw et al., 2022 ), and in some cases, abnormal myocardial enzyme is reported ( Herr et al., 2011 ; Dinkar et al., 2020 ; Kaiser et al., 2020 ).…”

Association of Apolipoprotein A Gene Polymorphism with Uncomplicated Plasmodium falciparum Malaria in Elfasher City, North Darfur, Sudan

“…The levels of LDL and HDL were observed in these patients, the average was 56.6 and 56.2, respectively. A study from India [16] reported triglyceride result was higher than the normal reference range in malaria, which was in disagreement with our results, while we found similar results of cholesterol and LDL levels of the study participants were within the normal reference range. Several studies have reported a significant association between LPL gene polymorphisms and lipids profile [17].…”

Malaria: biochemical, physiological, diagnostic, and therapeutic updates

“…This can be explained by the invasion of hepatic cells by the parasite and the leakage of liver enzymes into the circulation. The increase in liver enzyme levels is also proportional to the severity of the malaria infection ( Megabiaw et al, 2022 ; Ahad et al, 2022 ). Liver dysfunction in malaria cases results from congestion, cellular inflammation, and sinusoidal blockage caused by the parasite ( Auta, Zakariyya & Everest, 2018 ).…”