Abnormal findings on dipstick urinalysis of out-patients with malaria in Abakaliki, Nigeria.
OBJECTIVE
Malaria, one of the major health challenges of the tropics affecting about 500 million people, particularly the children and pregnant women have been associated with changes in urine compositions. The present study was undertaken to document the urinary abnormalities in malaria patients based on malaria species and the level of malaria parasitaemia.


METHODS
Febrile patients (n = 365) with positive Giemsa - stained blood films for malaria recruited from Outpatient Department of Ebonyi State University Teaching Hospital, Abakaliki participated in the study. Patients were classified into two categories (+ and ++) based on parasite density. Apparently healthy individuals (n = 81), without malaria parasite on both thick and thin films of comparable age and gender acted as control group. Urine sample (10 ml) was collected from each participant and analysed using standard laboratory methods and techniques.


RESULTS
Seventy - four (20.3%) of the patients had Plasmodium falciparum malaria. Although all the urine parameters were higher in the malarial patients in comparison to the control, only bilirubinuria and urobilinogenuria were statistically significant (p <0.05). Also, bilirubinuria, urobilinogenuria, haematuria and proteinuria were significantly (p < 0.05) higher in P. falciparum infection than in infections with other malaria species, but only in P. falciparum infection, bilirubinuria and urobilinogenuria were significantly (p < 0.05) higher at higher parasitaemia.


CONCLUSIONS
Even though positive blood film for malaria parasite remains the gold standard for the diagnosis of malaria, urinary abnormalities, such as bilirubinuria, urobilinogenuria, proteinuria and haematuria may aid in identifying patients with severe malaria parasitaemia, especially the falciparum malaria.
Department of Chemical Pathology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria. ugwuja@yahoo.com
E I
EI
Ugwuja
N C
NC
Ugwu
D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000652:urine*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006417:Hematuria / Q000652:urine; D006801:Humans; D007565:Jaundice / Q000469:parasitology; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D018512:Parasitemia / Q000175:diagnosis / Q000469:parasitology / Q000652:urine*; D010961:Plasmodium / Q000302:isolation & purification; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis / Q000652:urine*; D011507:Proteinuria / Q000652:urine; D016482:Urinalysis / Q000379:methods / Q000592:standards; D014558:Urobilinogen / Q000652:urine*; D055815:Young Adult
D014558:Urobilinogen; D001663:Bilirubin