Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat
Chewer Malaria Patients in Ethiopia
#MMPMID26173100
Ketema T
; Bacha K
; Alemayehu E
; Ambelu A
PLoS One
2015[]; 10
(7
): e0131212
PMID26173100
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Although more emphasis has been given to the genetic and environmental factors
that determine host vulnerability to malaria, other factors that might have a
crucial role in burdening the disease have not been evaluated yet. Therefore,
this study was designed to assess the effect of khat chewing on the incidence of
severe malaria syndromes and immune responses during malaria infection in an area
where the two problems co-exist. Clinical, physical, demographic, hematological,
biochemical and immunological data were collected from Plasmodium falciparum
mono-infected malaria patients (age ? 10 years) seeking medication in Halaba
Kulito and Jimma Health Centers. In addition, incidences of severe malaria
symptoms were assessed. The data were analyzed using SPSS (version 20) software.
Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%).
Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were
significantly lower (P<0.05) among khat chewer malaria patients. However,
relative risk to jaundice and renal failure were significantly higher (P<0.05) in
khat chewers than in non-khat chewer malaria patients. Longer duration of khat
use was positively associated with incidence of anemia. IgM and IgG antibody
titers were significantly higher (P<0.05) among khat chewer malaria patients than
among malaria positive non-chewers. Although levels of IgG subclasses in malaria
patients did not show significant differences (P>0.05), IgG3 antibody was
significantly higher (P<0.001) among khat chewer malaria patients. Moreover, IgM,
IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001) with
parasite burden and clinical manifestations of severe malaria symptoms, but not
with severe anemia and hypoglycemia. Additionally, a significant increment
(P<0.05) in CD4+ T-lymphocyte population was observed among khat users. Khat
might be an important risk factor for incidence of some severe malaria
complications. Nevertheless, it can enhance induction of humoral immune response
and CD4+ T-lymphocyte population during malaria infection. This calls for further
investigation on the effect of khat on parasite or antigen-specifc protective
malaria immunity and analysis of cytokines released upon malaria infection among
khat chewers.
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