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Pediatr Infect Dis J. 2017 Feb;36(2):146-150. doi: 10.1097/INF.0000000000001382.

Brain-derived Neurotrophic Factor Is Associated With Disease Severity and Clinical Outcome in Ugandan Children Admitted to Hospital With Severe Malaria.

Author information

1
From the *Department of Medicine, and †Sandra A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada; ‡Division of Pediatric Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada; §Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda; ¶Department of Pediatrics and Child Health, Mulago Hospital and Makerere University, Kampala, Uganda; ‖Department of Medicine, University of Washington, Seattle, Washington; and **Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Malaria remains a leading cause of childhood death and neurologic disability in sub-Saharan Africa. Here, we test the hypothesis that malaria-induced alterations to circulating brain-derived neurotrophic factor (BDNF) are associated with poor clinical outcomes in children with severe malaria.

METHODS:

We quantified BDNF (by enzyme-linked immunosorbent assay) in plasma samples collected [at presentation (day 1), day 3 and day 14], during a prospective study of Ugandan children admitted to hospital with severe malaria (n = 179).

RESULTS:

BDNF concentration at presentation (day 1) was lower in children with cerebral malaria (P < 0.01), coma (P < 0.01), Lambaréné Organ Dysfunction Score >1 (P < 0.05) and respiratory distress (P < 0.01). Higher BDNF concentration at presentation was associated with shorter time to coma recovery [hazard ratio = 1.655 (1.194-2.293); P = 0.002] and a reduced odds ratio of disability [0.50 (0.27-0.94); P = 0.047] and death [0.45 (0.22-0.92); P = 0.035]. BDNF concentration was lower on day 1 and increased in children surviving severe malaria (day 14; P < 0.0001).

CONCLUSIONS:

Our findings provide the new evidence linking circulating BDNF with disease severity, coma recovery and clinical outcome in children with severe malaria.

PMID:
27798544
DOI:
10.1097/INF.0000000000001382
[Indexed for MEDLINE]

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