title: Determination of PCT on admission is a useful tool for the assessment of disease severity in travelers with imported Plasmodium falciparum malaria.
abstract: Procalcitonin (PCT) and C-reactive protein (CRP) may be useful to predict complicated forms of malaria. A total of 30 consecutive travelers diagnosed with Plasmodium falciparum malaria over a two-year period were included in the study. Patients with complicated Plasmodium falciparum malaria showed higher levels of parasitemia (P = 0.0001), PCT (P = 0.0018), CRP (P = 0.0005), bilirubinemia (P = 0.004), and a lower platelet count (P<0.0001) compared with patients with uncomplicated forms. PCT levels above 5 ng/mL showed the highest value of specificity (0.86) and positive predictive factor (0.67) among other parameters, and equal sensitivity (0.67) was displayed by CRP levels above 150 mg/dl. None of the patients with complicated malaria showed PCT levels within normal limits (<0.5 ng/ml). Both PCT and CRP correlated with parasitemia (P<0.001) and showed areas under ROC curve of 0.83. At multivariate analysis, only PCT was associated with an increased risk of complicated malaria (OR 8.2, IC 95% 1.2-57.2, P = 0.03). The determination of PCT on admission showed better results compared to CRP, platelet count, and bilirubinemia and can be useful in non-endemic areas for the initial clinical assessment of disease severity in travelers with Plasmodium falciparum malaria.
authors.forename: Elda
authors.initials: E
authors.lastname: Righi
authors.forename: Maria
authors.initials: M
authors.lastname: Merelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Arzese
authors.forename: Paola Della
authors.initials: PD
authors.lastname: Siega
authors.forename: Claudio
authors.initials: C
authors.lastname: Scarparo
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000175:diagnosis / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014195:Travel
chemical_list: D002116:Calcitonin; D002097:C-Reactive Protein