Assessment of Serum Iron, Manganese and Cu/Zn Ratio in the Course of falciparum Malaria among Ivorian Patients (Côte d’Ivoire)

Objectives: The question of interaction between endemic malaria infection and nutritional status of the host is always controversial and their relationship remains difficult to establish. Furthermore, the nutritional requirements of the host include some trace elements that are also essential for malaria parasite. The aim of this work was to assess serum titers of iron, manganese and Cu/Zn ratio, an indicator of oxidative stress during Falciparum malaria among ivorian patients.

Design & Methods: The study was conducted between January and June 2013 among 61 malaria infected subjects and 57 uninfected controls aged 8months to 45years. These were previously evaluated about their dietary habits during diagnosis by thick and thin blood smear. For each patient, serum titres of Fe, Zn, Cu and Mn were determined using atomic absorption spectrometry followed by determination of Cu/Zn ratio which is an indicator of oxidative stress.

Results: The mean of iron titers was of 0.75±0.10mg/L in malaria infected patients compared to 0.94±0.09mg/L in controls. Serum iron progressively decreased as parasitæmia increased, with the lowest mean value (0.46±0.06mg/L) observed when parasite density was >40000/µL. The serum variations of zinc, copper and manganese were not significant. However, the serum titers of zinc and copper in both groups studied were lower than the references; while manganese titer was high.

Conclusion: This study shows that Falciparum malaria decreases the serum iron and results in significantly lower iron at high parasitæmia. However, there was no significant variation in oxidative stress with parasitæmia. The fact that serum titers of zinc and copper in both the malaria infected subjects and the control group were lower than the reference levels raises the question of bioavailability and insufficient nutritional intake of these micronutrients, which may be a subject of further study.