Immunologic and Biochemical Alterations in Severe Falciparum Malaria: Relation to Neurological Symptoms and Outcome

The relation between the immune response and the clinical features of severe falciparum malaria was studied in Burundian adults with (n=31) and without (n=17) cerebral involvement. At the time of admission, mean values for age, temperature, and blood levels of hemoglobin, creatinine, bilirubin, and glucose were similar in the two groups. Plasma levels of tumor necrosis factor a, interferon γ, interleukin 10 (IL-10), and soluble intercellular adhesion molecule 1 were similarly elevated in the two groups. Mean parasite counts and mean plasma levels of soluble E-selectin were higher in severe noncerebral malaria than in cerebral malaria and were correlated with each other. After adjustment for parasitemia, levels of soluble E-selectin remained higher in noncerebral malaria