Changes in Liver Function Enzymes in Plasmodium falciparum Infected Malaria Patients in Ajeromi General Hospital, Lagos, Nigeria

Objective: This study is to determine the changes in liver function enzymes in P. falciparum-infected patients in Ajeromi ifelodun area of Lagos, Nigeria by examining changes in some liver enzymes: Aspartate Transaminase (AST), Alanine Transaminase (ALT) and Alkaline phosphatase (ALP) obtained from newly diagnosed cases of malarial infection yet to be treated.

Study Design: Seventy (70) human subjects comprising of 50 P. falciparum malarial infected and 20 non-infected (control) subjects between 10-60 years were selected for this study. Malaria positive subjects were divided into three groups based on the number of parasite per μl. Those that had parasitaemia below 10,000 parasites per μl were considered a mild infection, those that had parasitaemia above 10,000 parasites per μl were considered severe infections and those with parasitaemia below 1,000 parasites per μl were considered a low infection. RDT test and microscopy was carried out to ascertain the presence of P.falciparum. They were grouped based on age group, sex and level of parasitaemia.

Materials and Methods: Blood samples were collected for the determination of P. falciparum, level of parasitaemia and liver function enzymes Aspartate Transaminase (AST), Alanine Transaminase (ALT) and Alkaline Phosphatase (ALP). P. falciparum was determined by Rapid Diagnostic Test (RDT) and microscopy.

Results: There was a significant increase (P < 0.001) in the mean level of serum Aspartate Transaminase (AST), Alanine Transaminase (ALT) and a significant decrease in the mean level of alkaline phosphatase (ALP) in the P. falciparum-infected patients compared to the control subjects. AST level was found to be significantly higher (P<0.001) among age group (51- above) in the P. falciparum patients and significantly lower among age group (10-20) in the control subjects when compared to other age groups.

ALT level was significantly higher (P < 0.001) among age group (51- above) in the P. falciparum patients and significantly lower among age group (41-50) in the control subjects when compared to other age groups. ALP level was significantly higher (P < 0.001) among age group (41-50) in the P. falciparum patients and significantly lower among age group (10-20) in the control subjects when compared to other age groups. AST and ALT were found to be significantly higher (P < 0.001) in the high parasitaemia group when compared to the low and moderate parasitaemia group and they were also significantly higher in the moderate parasitaemia group than in the low parasitaemia group.ALP was significantly higher (P < 0.001) in the moderate parasitaemia group when compared to the low and high parasitaemia group and they were only marginally lower in the high than in the low parasitaemia group.

Conclusion: There was an elevated level of liver function enzymes in the P. falciparum patients than in the control subjects. This study shows that high parasitaemic patients are at greater risk of hepatic damage than the low parasitaemic group, hence early diagnosis and treatment of malaria are highly encouraged.