The association between malaria parasite geometrical mean and clinical spectrum of severe disease in a high-transmission setting in eastern Uganda : a cross-sectional study.

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dc.contributor.authorEgiru, Isaiah Eregu Emma
dc.contributor.authorNamayanja, Cate
dc.contributor.authorPaasi, George
dc.contributor.authorOkiror, William
dc.contributor.authorOngodia, Paul
dc.contributor.authorOkalebo, Benard Charles
dc.contributor.authorMuhindo, Rita
dc.contributor.authorAbongo, Grace
dc.contributor.authorOguttu, Faith
dc.contributor.authorOkibure, Ambrose
dc.contributor.authorOkello, Francis
dc.contributor.authorTegu, Crispus
dc.contributor.authorMukunya, David
dc.contributor.authorChebet, Martin
dc.contributor.authorOlupot-Olupot, Peter
dc.date.accessioned2026-07-01T14:15:59Z
dc.date.available2026-07-01T14:15:59Z
dc.date.issued2025
dc.descriptionResearch article
dc.description.abstractBackground: Malaria burden remains significant, especially in high-transmission settings. While some data show an association between severe malaria and high-malaria parasite geometrical mean (GM), few data describe this phenomenon in malaria hightransmission settings. We described the malaria parasite GM and clinical spectrum of severe malaria in Eastern Uganda to advance understanding of its implications on disease severity and patient outcomes. Methods: We conducted a cross-sectional study in Mbale Regional Referral Hospital (MRRH), Eastern Uganda. Children admitted with severe malaria confirmed by microscopy with ages between 2 months and 12 years were enrolled in the study from September 21, 2021, to September 21, 2022. Data were collected on patient sociodemographics, clinical symptoms and signs, laboratory parameters, treatment details, and outcomes. From the blood samples collected at the bedside, blood films/smears were made. The malaria parasite count was obtained from the patients’ smears by counting the malaria parasites against 200 white blood cells (WBCs). The GMs of malaria were obtained after the logarithmic transformation of the parasite counts. Data were analyzed using Stata 15, and significant associations were reported at p values of 0.05 at 95% confidence intervals. Results: A total of 376 children with a mean age of 4.65 years were recruited, of whom 57.71% (217/376) were male. Children under 5 years constituted 61.7% (232/376). The common clinical manifestations were prostration 76.9% (289/376), jaundice 55.6% (209/376), severe anemia 48.4% (182/377), and hemoglobinuria 46.5% (175/376). The overall malaria parasite GM was 12,238.42 parasites/microliter (95% CI: 9166.72–16,339.43). The highest GM of 197,000 parasites/microliter (95% CI:40,817.64–946,368) and the lowest of 8938.185 parasites/microliter (95% CI: 5932.8–13,466.01) were observed in shock and severe anemia, respectively. Inpatient mortality was 3.4%. Conclusion: In malaria high-transmission settings of Eastern Uganda, patients with severe malaria had low parasite GMs similar to those in uncomplicated malaria. Thus, malaria parasite GM should not be relied upon to determine disease severity in these settings.
dc.description.sponsorshipThe Mbale Clinical Research Institute ; Busitema University.
dc.identifier.citationEgiru, E. I. E., Namayanja, C., Paasi, G., Okiror, W., Ongodia, P., Okalebo, C. B., Muhindo, R., Abongo, G., Oguttu, F., Okibure, A., Okello, F., Tegu, C., Mukunya, D., Chebet, M., & Olupot-Olupot, P. (2025). The association between malaria parasite geometrical mean and clinical spectrum of Severe disease in a High‐Transmission Setting in Eastern Uganda: a Cross‐Sectional study. Journal of Parasitology Research, 2025(1), 4801721. https://doi.org/10.1155/japr/4801721
dc.identifier.urihttps://bdears.busitema.ac.ug/handle/123456789/7075
dc.language.isoen
dc.publisherWiley
dc.titleThe association between malaria parasite geometrical mean and clinical spectrum of severe disease in a high-transmission setting in eastern Uganda : a cross-sectional study.
dc.typeArticle
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