Ultrasonographic Hepatosplenic Parenchymal and Blood Flow Changes in Children with Acute Falciparum Malaria (original) (raw)

PubMed, 2021

Abstract

Background: Malaria, a major cause of morbidity and mortality in Nigerian children, is associated with biochemical, haematological, blood flow and clinical multiorgan changes, including changes in the spleen and the liver. Objectives: To investigate hepatosplenic pathologies in a Nigerian children cohort with acute P. falciparum malaria. Methods: A prospective case-control study of 260 children (65 uncomplicated malaria (UCM),65 complicated malaria (CM) cases and 130 controls) aged six months to six years. All subjects had laboratory tests and hepatosplenic parenchymal and blood-flow ultrasonographic evaluation. Results: Mean splenic length was 8.13cm (95% CI: 7.84cm, 8.41cm) and 7.42cm (95% CI: 7.13cm, 7.71cm) in CM and UCM (p=0.001) respectively, liver span was significantly different in controls and CM (p<0.001); controls and UCM (p=0.014). Portal vein flow velocity was 32.5cm/s, 25.4cm/s and 26.5cm/s in controls, UCM and CM (p=<0.001 and 0.004 respectively) while splenic flow velocity was 30.7cm/s and 25.8cm/s in controls and CM (p=0.022). Splenic artery peak systolic velocity (PSV) =73.78cm/s, 66.52cm/s and 59.35cm/s (p = 0.008) among controls, UCM and CM respectively. There was significant correlation between malaria parasite (MP) density and splenic length (r =0.239, p = 0.007), splenic artery pulsatility index (PI) (r = 0.300, p = 0.001), splenic artery resistivity index (RI) (r = 0.260, p = 0.003) and liver span. Conclusion: In children with acute malaria, the splenic vessels and portal vein blood flow velocities were reduced. High malaria parasite density evokes direct relationship with spleen and liver span, splenic artery RI and PI and portalvein diameter.

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