DETERMINING THE SERUM PROTEIN LEVELS AND CIC LEVEL IN CEREBRAL MALARIA PATIENTS


DETERMINING THE SERUM PROTEIN LEVELS AND CIC LEVEL IN CEREBRAL MALARIA PATIENTS

TABLE OF CONTENT

Title Page………………..i

Certification……………ii

Dedication………………iii

Acknowledgment……….iv

Abstract…………………vi

Table of content………vii

CHAPTER ONE

1.0    INTRODUCTION

1.1JUSTIFICATION

1.2 OBJECTIVES OF THIS STUDY

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 DEFINITION OF MALARIA

2.2 HISTORICAL OUTLINE

2.3 COMMON FEATURES

GENERAL CHARACTERISTICS OF MALARIA AS A DISEASE.

2.3.1 PERIODICITY

2.3.2 RELAPSES

2.3.3 CAUSE OF DEATH

2.3.4 SENSITIZATION

2.3.5 HOST FACTORS

2.4 PATHOLOGICAL AND PATHOPHYSIOLOGICAL CHANGES

2.5 MALARIA SPECIES IN MAN

2.5.1 PLASMODIUM VIVAX

2. 5.2 PLASMODIUM OVALE

2.5.3 PLASMODIUM MALARIA

2.5.4PLASMODIUM FALCIPARUM

2.6 LIFE CYCLE 2.6.1

2.6.2 PARASITE IN VERTEBRATE HOST

2.6.2.1 TISSUE PHASE

2.6.2.2 ERYTHROCYTIC PHASE

2.6.23 ULTRASTRUCTURE

2.7MALARIA IN PREGNANCY

2.8 MALARIA IN CHILDREN

2.8.1CONGENITAL AND NEONATAL MALARIA

2.9 IMMUNITY IN MALARIA

2.9.1DIAGNOSIS

2.10 SERUM PROTEINS IN MALARIA

2.11 BIOCHEMISTRY OF CIRCULATING IMMUNE COMPLEX

2.12 CIRCULATING IMMUNE COMPLEXES IN MALARIA

CHAPTER THREE

3.0 MATERIALS AND METHODS

3.1 APPARATUS AND EQUIPMENT

3.2CHEMICALS AND REAGENTS

3.3 PREPARATION OF REAGENTS

3.3.1 REAGENT FOR TOTAL PROTEIN

3.3 .2 REAGENT FOR ALBUMIN

3.3.3 REAGENTS FOR CIRCULATING IMMUNE COMPLEXES

3.3.4POLYETHYLENE GLYCOL (PEG) 6000 SOLUTION

3.4 STUDIED PATIENTS AND SUBJECTS

3.5 SAMPLE COLLECTION

3.6 ESTIMATION OF SERUM TOTAL PROTEIN

3.7 ESTIMATION OF SERUM ALBUMIN BY BROMOCRESOL GREEN

3.8 ASSAY OF CIRCULATING IMMUNE COMPLEXES (CICs)

3.9 SERUM GLOBULIN DETERMINATION

3.10 STATISTICAL ANALYSIS

CHAPTER FOUR

4.0 RESULTS

CHAPTER FIVE

5.0 DISCUSSION AND CONCLUSION

5.1 DISCUSSION

5.2 CONCLUSION

5.3 RECOMMENDATION

REFERENCES

APPENDIX I

CHAPTER ONE

1.0     INTRODUCTION

Malaria is a febrile illness characterized by fever and related symptoms (WHO, 1990).

It is a disease caused by a blood-borne protozoan parasite which is an intracellular parasite belonging to the class Sporozoa and of the genus Plasmodium and it is transmitted through the bite of an infected female anopheles mosquito (CDC, 2002). There are four different parasites of this genus that may give rise to malaria in man.

Malaria is probably one of the oldest diseases known to mankind that has a profound impact on our history. The history of malaria and its terrible effects is as ancient as the history of civilization, therefore the history of mankind itself (Ray et al., 1992). This ancient disease is still the scourge of the tropic and subtropics Africa, the Middle East, Asia, and China, and Central and South America are all endemic zones with tens of Ilion cases annually (Lucas, 1992).

Plasmodium falciparum is one of the genus and causes the most ere and virulent form of the disease and the only one to cause acute ability. In this study, Plasmodium falciparum will be on focus since it is most prevalent in Nigeria. This genus of malaria spends a part of its cycle in the red cell of the host where the erythrocytic schizogony. They develop into merozoites and undergo cycle-producing schizonts.

Each cycle terminates when the red cell rupture releasing merozoites into the circulation to infect new red cells eliciting an immune response.

Malaria infection leads to the formation of circulating immune complexes (Mibeiet al., 2005). The importance of circulating immune complexes (CIC) and their relationship to various diseases has been the subject of investigation for a number of years. The formation of immune complexes is a protective, ongoing, and usually benign process of a normally functioning immune system. However, in some individual CIC are deposited in the walls of blood vessels, especially in the glomerular capillaries where they cause tissue damage.

The biospecific binding between sites of the antibody and the determinant group of the antigen results in the formation of antigen-antibody complex (AgAb) known as immune complexes (McDougal and McDuffie, 1985). Since malaria has been known to cause mortality this study is aimed at assessing the magnitude of circulating immune Complexes and some biochemical parameters which include serum total rein, albumin, and globulin.

1.1JUSTIFICATION

The science of immunology has suggested the use of CIC to measure a variety of clinically oriented conditions, this current studies, suggest that CIC determination can be important in the evaluation of disease and sometimes in monitoring the efficiency of therapy.

Studies have suggested that plasma protein pattern is frequently abnormal in patients with acute malaria and disturbance in immune responses makes the disease a major cause of morbidity and mortality in patients with malaria.

There is, therefore, a need to determine CIC and serum proteins in patients suffering from malaria with a view to understanding the pathology of the infection.

1.2 OBJECTIVES OF THIS STUDY

This study is aimed at:

Determining the serum protein levels and CIC level in cerebral malaria patients, those currently on treatments, severe malaria, and apparently healthy individuals. Comparing the level among the different groups studied. Making recommendations based on the results obtained and use of CIC in the diagnosis of malaria.

CHAPTER TWO

2.0 LITERATURE REVIEW 

2.1 DEFINITION OF MALARIA 

Malaria is an infectious disease caused by the parasite called plasmodia, mosquito borne disease of humans resulting from infection of the parenchyma cell of the liver and red cells by sporozoa belonging to the genus plasmodium (Gilles, 1991). It is transmitted by the female anopheles mosquito. It is a disease that can be treated in just 48 hrs, yet it can cause fatal complications if the diagnosis and treatments are delayed. It is reemerging as the number one killer and it is the number one priority tropical disease of the World Health Organization (Gilles, 1991). 

This ancient disease is still the scourge of the tropics and subtropics. Africa, the middle East, Asia and China and Central and South America are all endemic zones with tens of million cases annually (Lucas, 1992). Its dissemination diminishes with distance from the equator. Malaria ranks third among the major infectious disease in causing death-after pneumococcal acute respiratory infection and tuberculosis. It is expected that by the turn of the century malaria would be number one infectious killer disease in the world (Ray et al., 1992).

2.2 HISTORICAL OUTLINE

 It is assumed that the evolution and history of mammalian plasmodia started with the adaptation of coccidian of intestinal epithelium to some tissues of the internal organs and then to the invasion of free cells in the blood. The next step was the possible transmission of the parasite from one animal to another by blood sucking arthropod vectors. It is confirmed that well over 100 parasite species similar to those of humans are found in a wide range of vertebrates from reptiles or birds to higher apes. None can be transmitted to man except that found in monkeys. 

It was probable that the disease originated from Africa. The establishment of malaria in the new world is actually known. Plasmodium vivax and Plasmodiummalaria were thought to be brought by trans-pacific voyages from South-east Asia. While Plasmodium falciparum is of Post-Colombian American. References to seasonal and intermittent fevers exist in the ancient Assyrian, Chinese and Indian and medical tests but their true identity with malaria is uncertain but is usually ascribed to punishment of gods or vengeance by evil spirits and is met by incantations or sacrificial offerings. Hippocrates who lived in Greece in fifth century BC were the earliest physicians to discard superstition for logical observation of the relationship between the appearance of the disease and his patients lived and was first to describe in detail the clinical picture of malaria and some complications of disease. Various references were also given by many other physicians in Greece and Rome. It was then treated using drainage practices. Later Peruvian bark also referred to as Corncko cinchona was discovered and used for treatment of fevers. 

Malaria was linked with poisonous vapours of swamps or stagnant water on the ground since time immemorial. This probable relationship was so firmly established that it gave the two most frequently used names to the disease mal’aria, later shortened to one word malaria and paludisme. The term malaria (from the Italian mala "bad" and aria "air") was used by the Italians to describe the cause of intermittent fever associated with exposure to marsh air or masma. However, various intermittent fever had been called jungle fever, marsh fever, paludal fever or swamp fever (Gilles and Warrel, 1983). 

In 1880, Lareran, a French army surgeon in Algeria first saw and described malaria parasites in the blood cells of human beings. Patrick Manson, a Scotsman who was practicing medicine in China discovered in 1878 that mosquitoes are arthropod hosts of Filarial parasites found in the blood. The confirmation of the fact that malaria is transmitted by Anopheles mosquito was based on combined field experiment carried out by Patrick Manson and his colleagues near Rome and in London in 1900after series of work carried out by some early scientists (Gilles et al., 1977). 

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DETERMINING THE SERUM PROTEIN LEVELS AND CIC LEVEL IN CEREBRAL MALARIA PATIENTS



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