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. Socio-demographic 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.

Keywords:

• malaria
• anti-malaria drug
• liver enzymes
• lipid profiles
• Ethiopia

Abbreviations

ALT, alanine amino-transferase; ALP, alkaline phosphatase; ACTs, artemisinin-based combination therapies; AST, aspartate amino-transferase; BF, blood film; CQ, chloroquine; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HDL, high density lipoprotein; LFTs, liver function tests; LDL, low-density lipoprotein; OPD, outpatient department; SOPs, standard operation procedures; TC, total cholesterol; VLDL, very low-density lipoproteins; WBCs, white blood cells.

Data Sharing Statement

All data is included in the manuscript.

Ethics Approval and Consent to Participate

The study was conducted after ethical approval was obtained from the Research and Ethics Committee of the School of Biomedical and Laboratory Science, College of Medicine and Health Sciences & Specialized Hospital, University of Gondar. Following an explanation on the purpose, benefits, and the possible risks of the study, written informed consent was obtained from adults/guardians and ascents were obtained from all study participants. The participants were informed they were free to withdraw from the study at any time. Compensation for transport was provided for every patient’s scheduled visit. The study complies with the declaration of Helsinki.

Acknowledgments

The authors would like to express deepest gratitude for study participants for their interest to participate in the study. We also acknowledge Dembia primary hospital, Teda health center, and University of Gondar comprehensive specialized hospital clinical chemistry staffs for their contribution to the entire work of data collection and processing. Our gratitude goes to the University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Medical Parasitology for letting us to do this public health important research work.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work.

Additional information

Funding

The research was financially supported by University of Gondar.