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  1. Cecilia Lekpor1,
  2. Felix Botchway1,
  3. Jonathan Stiles2,
  4. Wilson O Nana2
  1. 1Department of Patholgy, University of Ghana, Accra, Ghana
  2. 2Morehouse School of Medicine, Atlanta (GA), USA


Background Malaria mortality is associated with exaggerated host responses to inflammatory factors such as C-X-C motif chemokine 10 (CXCL10) and host biomarkers such as angiopoietin 1 (Ang-1) and angiopoietin 2 (Ang-2). The aim of this study was to determine saliva levels of CXCL10, Ang-1 and Ang-2 and compare with plasma levels regarding their potential as biomarkers of malaria, which may be useful for further development of highly efficient non-invasive malaria detection methods.

Methods Case control study involving 213 subjects (119 with and 94 without malaria) aged 1–16 years. Haematological determination was done using Haematology Analyser. Plasmodium Lactate Dehydrogenase/Histidine Rich Protein-2 (pLDH/HRP-2) Antigen rapid diagnostic test (RDT) were performed. Plasma and saliva levels of CXCL10, Ang-1 and Ang-2 were measured using Elisa kit. Data was presented as mean ±standard error or median and interquartile range (IQR). A p-value<0.001 was considered statistically significant.

Results There was decreased plasma levels of Ang-1 and increased plasma levels of CXCL10 and Ang-2 in individuals with malaria compared to those without malaria (Ang-1, p<0.009; Ang-2, p<0.001; CXCL10 p<0.001). Biomarker levels in both plasma and saliva in subjects with malaria and without malaria were correlated and a significant relationship was found between Ang −2 and CXCL10 which could be used to predict malaria severity (p=0.001 for Ang-2 and p<0.01 for CXCL10). Low Ang-1 and high Ang-2 in both plasma and saliva were significantly associated with increased risk of malaria severity: Ang-1, 2741.04 (1785.85–3582.68), p<0.009; Ang-2, 3508.82 (2139.61–5091.633.9), p<0.001 and Ang-1, 720.27 (439.82–1086.74); 16.98 (10.08–33.26), (p<0.001 for all). Finally, Ang-2 was informative when combined with CXCL10 to predict malaria severity.

Conclusion These results provide insight into the use of saliva for a non-invasive diagnostic method and demonstrate that Ang-2 combined with CXCL10 is a promising predictive biomarker of malaria severity.

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