Academic journal article Iranian Journal of Public Health

Electrolyte Disturbance and the Type of Malarial Infection

Academic journal article Iranian Journal of Public Health

Electrolyte Disturbance and the Type of Malarial Infection

Article excerpt


Malaria is one of the most widespread infectious diseases among humans. People from more than 100 countries suffer from the havoc caused by malaria. World Health Organization (WHO) estimated 198 million cases and 5, 84,000 deaths due to malaria in 2013(1). Malaria is endemic in tropical and subtropical regions with highest prevalence in Africa and Southeast Asia. Pakistan, being a subtropical country, provides good habitat to mosquitoes and bears strong malarial burden. WHO declares Pakistan among one of the six countries with the highest malaria transmission in 2013 (1). Five species of Plasmodium are known to infect humans; these include P. falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi. P. vivax and P. falciparum were recognized as the main agents responsible for malaria in Pakistan. Prevalence of malaria due to P. vivax is high in Pakistan (1,2).

Electrolytes are minerals present in blood and other body fluids. There optimum range is essential for proper physiological activities (3). Electrolyte imbalances and mineral disturbances were known to be common clinical manifestations in several infectious diseases including malaria. Hyponatraemia, hyperkalaemia, hypocalcaemia and hypomagnesaemia usually develops because of infection with Plasmodium (4).

Sodium (Na) is known as the major cation of exracellular fluid. It regulates the normal distribution of water and osmotic pressure in various body fluids. Various health problems occur due to Na+ ion disturbance (5). Hyponatraemia, the decline in the Na concentration, is considered as an important clinical manifestation of malaria. Decreased level of Na exaggerates the disease symptoms and results in severe malaria (6). Potassium (K) is identified as a crucial electrolyte for accurate functioning of all body cells, tissues and organs. It maintains blood pH and water levels in the body. It is particularly important in skeletal and smooth muscle contraction. Hypokalaemia is a common complication of severe malaria. Decreased level of K is an obvious correction of acidosis in malaria (7). Calcium (Ca) is considered as an essential nutrient for human body. It provides strength to bones and teeth. It plays an important role in the maintenance of health and nutritional qualities (8). Low level of Ca is a common observation during malaria infection. Decline in calcium occurs due to clinical symptoms associated with malaria like fever, high pulse rate, sweating and shivering (9). Magnesium (Mg) is known as an important element that acts as a cofactor of more than 300 enzymes. It regulates protein synthesis, blood glucose, blood pressure, neuromuscular function and several other biochemical reactions (10). Its levels usually drop because of malaria mostly in case of P. falciparum (11).

Prevalence of malaria is very high in Pakistan. P. vivaxand P. falciparum impart heavy health burdens on the local population of Pakistan. Electrolyte imbalance appears because of malaria and may lead towards the severity of disease.

The present study aimed to find out the levels of Na, K, Ca and Mg in malarial patients suffering from both P. vivax and P. falciparum.

Materials and Methods

Sample collection

All procedures complied with the declaration of Helsinki. The Advance Research and Study Board, University of Sargodha approved the protocol of present study. Prior permission was also taken from the Ethical Committee of the University of Sargodha.

After taking proper consent and completion of ethical criteria, blood samples of 173 individuals were collected and stored at -20°Cuntil further processing. Blood samples of 73 malarial patients were collected from different hospitals in district Sargodha, Punjab, Pakistan from March 2013 to February 2014.Patients were categorized into two groups, P. falciparum and P. vivax, on the basis of causative species of Plasmodium for malaria. Forty samples were placed in P. falciparum group and 33 in P. …

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