Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria
Abstract Background Most clinicians in developed, non-malaria endemic countries have limited or no experience in making clinical assessments of malaria disease severity and subsequent decisions regarding the need for parenteral therapy or high-level monitoring in febrile patients with imported malar...
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Online Access: | https://doi.org/10.1186/1475-2875-9-255 https://doaj.org/article/c7549d42cb6f4a42923bf26e94944b96 |
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ftdoajarticles:oai:doaj.org/article:c7549d42cb6f4a42923bf26e94944b96 2023-05-15T15:14:13+02:00 Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria te Witt René van Wolfswinkel Marlies E Petit Pieter L van Hellemond Jaap J Koelewijn Rob van Belkum Alex van Genderen Perry JJ 2010-09-01T00:00:00Z https://doi.org/10.1186/1475-2875-9-255 https://doaj.org/article/c7549d42cb6f4a42923bf26e94944b96 EN eng BMC http://www.malariajournal.com/content/9/1/255 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-255 1475-2875 https://doaj.org/article/c7549d42cb6f4a42923bf26e94944b96 Malaria Journal, Vol 9, Iss 1, p 255 (2010) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2010 ftdoajarticles https://doi.org/10.1186/1475-2875-9-255 2022-12-31T12:58:37Z Abstract Background Most clinicians in developed, non-malaria endemic countries have limited or no experience in making clinical assessments of malaria disease severity and subsequent decisions regarding the need for parenteral therapy or high-level monitoring in febrile patients with imported malaria. In the present study, the diagnostic accuracy of plasma soluble Triggering Receptor Expressed on Myeloid cells 1 (TREM-1), neopterin and procalcitonin levels as biomarkers for severe Plasmodium falciparum disease was evaluated in 104 travellers with imported malaria (26 patients with non- P. falciparum malaria, 64 patients with uncomplicated P. falciparum malaria and 14 patients with severe P. falciparum malaria). Methods TREM-1, neopterin and procalcitonin were determined in serum using commercially available ELISA or EIA tests. The diagnostic performance of these biomarkers for severe disease was compared with plasma lactate, a well-validated parameter for disease severity in patients with malaria, as reference. Severe malaria was defined according to the modified WHO criteria. Results No significant differences in TREM-1 levels were detected between the different patient groups. Patients with severe P. falciparum malaria had significantly higher neopterin and procalcitonin levels on admission when compared to patients with uncomplicated P. falciparum malaria or non- P. falciparum malaria. Receiver Operating Characteristic (ROC) curve analysis showed that neopterin had the highest Area-Under-the-ROC curve (AUROC 0.85) compared with plasma lactate (AUROC 0.80) and procalcitonin (AUROC 0.78). At a cut-off point of 10.0 ng/ml, neopterin had a positive and negative predictive value of 0.38 and 0.98 whereas procalcitonin, at a cut-off point of 0.9 ng/ml, had a positive and negative predictive value of 0.30 and 1.00. Conclusion Although the diagnostic value of neopterin and procalcitonin is limited, the high negative predictive value of both neopterin and procalcitonin may be helpful for a rapid exclusion of severe ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Eia ENVELOPE(7.755,7.755,63.024,63.024) Malaria Journal 9 1 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 te Witt René van Wolfswinkel Marlies E Petit Pieter L van Hellemond Jaap J Koelewijn Rob van Belkum Alex van Genderen Perry JJ Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Most clinicians in developed, non-malaria endemic countries have limited or no experience in making clinical assessments of malaria disease severity and subsequent decisions regarding the need for parenteral therapy or high-level monitoring in febrile patients with imported malaria. In the present study, the diagnostic accuracy of plasma soluble Triggering Receptor Expressed on Myeloid cells 1 (TREM-1), neopterin and procalcitonin levels as biomarkers for severe Plasmodium falciparum disease was evaluated in 104 travellers with imported malaria (26 patients with non- P. falciparum malaria, 64 patients with uncomplicated P. falciparum malaria and 14 patients with severe P. falciparum malaria). Methods TREM-1, neopterin and procalcitonin were determined in serum using commercially available ELISA or EIA tests. The diagnostic performance of these biomarkers for severe disease was compared with plasma lactate, a well-validated parameter for disease severity in patients with malaria, as reference. Severe malaria was defined according to the modified WHO criteria. Results No significant differences in TREM-1 levels were detected between the different patient groups. Patients with severe P. falciparum malaria had significantly higher neopterin and procalcitonin levels on admission when compared to patients with uncomplicated P. falciparum malaria or non- P. falciparum malaria. Receiver Operating Characteristic (ROC) curve analysis showed that neopterin had the highest Area-Under-the-ROC curve (AUROC 0.85) compared with plasma lactate (AUROC 0.80) and procalcitonin (AUROC 0.78). At a cut-off point of 10.0 ng/ml, neopterin had a positive and negative predictive value of 0.38 and 0.98 whereas procalcitonin, at a cut-off point of 0.9 ng/ml, had a positive and negative predictive value of 0.30 and 1.00. Conclusion Although the diagnostic value of neopterin and procalcitonin is limited, the high negative predictive value of both neopterin and procalcitonin may be helpful for a rapid exclusion of severe ... |
format |
Article in Journal/Newspaper |
author |
te Witt René van Wolfswinkel Marlies E Petit Pieter L van Hellemond Jaap J Koelewijn Rob van Belkum Alex van Genderen Perry JJ |
author_facet |
te Witt René van Wolfswinkel Marlies E Petit Pieter L van Hellemond Jaap J Koelewijn Rob van Belkum Alex van Genderen Perry JJ |
author_sort |
te Witt René |
title |
Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
title_short |
Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
title_full |
Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
title_fullStr |
Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
title_full_unstemmed |
Neopterin and procalcitonin are suitable biomarkers for exclusion of severe Plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
title_sort |
neopterin and procalcitonin are suitable biomarkers for exclusion of severe plasmodium falciparum disease at the initial clinical assessment of travellers with imported malaria |
publisher |
BMC |
publishDate |
2010 |
url |
https://doi.org/10.1186/1475-2875-9-255 https://doaj.org/article/c7549d42cb6f4a42923bf26e94944b96 |
long_lat |
ENVELOPE(7.755,7.755,63.024,63.024) |
geographic |
Arctic Eia |
geographic_facet |
Arctic Eia |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 9, Iss 1, p 255 (2010) |
op_relation |
http://www.malariajournal.com/content/9/1/255 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-255 1475-2875 https://doaj.org/article/c7549d42cb6f4a42923bf26e94944b96 |
op_doi |
https://doi.org/10.1186/1475-2875-9-255 |
container_title |
Malaria Journal |
container_volume |
9 |
container_issue |
1 |
_version_ |
1766344692450983936 |