Influence of Gender on Some Red Cell Indices, L-Arginine and D-dimer in Malaria Parasite Severity amongst Children Resident in Rivers State, Nigeria

Aim: The aim of the study was to assess the influence of gender on malaria parasite severity in children resident in Rivers State, Nigeria.

Study Design: The study was cross-sectional observational study.

Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between the month of March and August 2020.

Methodology: A total of 822 pediatrics (0-16 years), were randomly selected for this study after due parental consent. 5ml of venous blood was collected from each subject: 1ml was dispensed into paediatric EDTA (for haematologic and parasite density) and 4 ml into sodium citrate bottle for L-arginine assay by ELISA-method, while Full blood count was determined using haematological auto-analyser, Mindray BC-6800. Malaria density was determined by microscopic method using thick and thin Giemsa stained blood smears. Level of significance was set at P<0.05.

Results: There was a significant decrease (p<.05) in the mean (41.04±3.80%) neutrophil count in female subject with complicated malaria compared with the control (42.81±0.98%) as against a significant decrease in mean (37.71±0.96%) neutrophil count of female subject with uncomplicated malaria. A significant decrease in neutrophil (28.05±3.37%) of male subjects with complicated malaria and uncomplicated malaria (36.10±0.79%) was seen when compared to control (44.32±0.88%). Again, a significant decrease (p<.05) in eosinophil count of female with complicated malaria (3.32±0.74%) was seen when compared with the control subject (3.81±0.19%) and no significant difference was seen in female subjects with uncomplicated malaria (3.62±0.19%) when compared with the control. A significant increase in eosinophil was seen in male subjects with complicated malaria (4.47±0.66%) and uncomplicated malaria (4.52±0.16%) when compared with the control (3.88±0.17%). There was observed a significant difference (p<.001) in the mean L-arginine values of female subjects with complicated (39.22±9.57pg/ml) and uncomplicated (65.13±2.41 pg/ml) malaria compared with the control (42.85±2.48 pg/ml). However, no significant difference was seen in male subjects with complicated (33.21±8.49) and uncomplicated (45.51±2.00 pg/ml) malaria when compared with control (47.97±2.21 pg/ml). Also, a significant difference (p<0.0019) was seen between the mean D2D values of female subjects with complicated (6436.64±568.94 pg/ml) and uncomplicated (2824.55±143.46 pg/ml) malaria among the study subjects as against the control (1866.39±147.35 pg/ml).

Conclusion: In conclusion, this study showed a trend between gender and malaria type did not significantly change haematological parameters with the exception of the immune cells such as NEU, LYM, and EOS. However, a significant increase in L-arginine among female subjects was seen indicating a faster rate of malaria clearance.