Utility Of Circulating Levels Of Tumour Necrosis Factor And Its Soluble Receptor 2 In Children With Plasmodium Falciparum Malaria

Tumour Necrosis Factor TNF constitutes a major signature pro-inflammatory cytokine in P.falciparum malaria. Low TNF levels are considered critical in controlling P. falciparum malaria parasitaemia although high levels of TNF that mediate a strong inflammatory response which if not well regulated can lead to immunopathology and severe forms of malaria that may lead to fatalities. The biological activity of TNF can be regulated by soluble Tumour Necrosis Factor Receptors sTNFRs sTNFR1 and sTNFR2.Whereas sTNFR1 is constitutively expressed in most tissues sTNFR2 is tightly regulated during an inflammatory response. It was a case control study in age and sex-matched children under 5 years of age with P.falciparum malaria and healthy controls done at Bungoma County Hospital. A sample size of 48 children was derived based on a similar study it was ultimately comprised of 23 P. falciparum malaria infected children and 24 non-malaria infected controls they were selected by simple random sampling. Subjects were selected on the basis of parasitaemia defined based on WHO criteria.The average age across all cohorts was 33 months. In cases on day 1 the average TNF levels were 295.7 pgml and sTNFR2 levels were 155.0 pgml and on day 3 TNF levels were 200 pgml while sTNFR2 levels were 52.1 pgml compared to controls in which TNF levels were 68.2 pgml while sTNFR2 levels were 27 pgml. TNF and sTNFR2 levels were significantly elevated in this study which was indicative of TNF and sTNFR2 utility in distinguishing the various falciparum malaria disease states.