» Articles » PMID: 37478118

Evaluation of CRP As a Marker for Bacterial Infection and Malaria in Febrile Children at the Douala Gyneco-Obstetric and Pediatric Hospital

Overview
Journal PLoS One
Date 2023 Jul 21
PMID 37478118
Authors
Affiliations
Soon will be listed here.
Abstract

Background: C reactive protein (CRP), a marker for the presence of inflammation, has been extensively studied for distinguishing bacterial from non-bacterial infection in febrile patients, but its role in excluding malaria in the febrile child has not been thoroughly evaluated.

Method: This was a cross-sectional study at the Douala Gyneco-Obstetric and Pediatric Hospital which included all patients between the ages of one month and 16 years presenting with fever. Consenting patients received complete clinical examinations, then venous blood samples were collected and tested for CRP values, bacterial infection and malaria.

Results: Samples of 220 children were analyzed. 142/220 had viral infections, 50/220 had malaria and 49/220 had bacterial infections. 7/220 had both malaria and bacterial infection. There was no significant difference between mean CRP values in malaria and bacterial infection (p = 1), but CRP means were significantly higher in malaria/bacterial infection than in viral infection (p<0.0001). Area Under the Receiver Operating Characteristics Curve (AUROC) values were 0.94 for malaria and 0.86 for bacterial infection, with a calculated cut-off of 23.6mg/L for malaria and 36.2mg/L for bacterial infection. At these cut-offs, CRP had a Positive Predictive Value (PPV) of 68.75% and 85.00% for malaria and bacterial infection respectively, with a Negative Predictive Value (NPV) of 94.74% and 89.05% respectively.

Conclusion: CRP can effectively exclude malaria and bacterial infection in febrile children in low-resource settings without the need for additional tests.

Citing Articles

C-reactive protein-induced injury in -infected lung epithelial cells is mediated by the P38 MAPK/mitochondrial apoptosis pathway.

Li L, Zhang Y, Zhao L, Shi Y Microbiol Spectr. 2025; 13(3):e0162624.

PMID: 39932324 PMC: 11878036. DOI: 10.1128/spectrum.01626-24.

References
1.
Parikh R, Mathai A, Parikh S, Sekhar G, Thomas R . Understanding and using sensitivity, specificity and predictive values. Indian J Ophthalmol. 2007; 56(1):45-50. PMC: 2636062. DOI: 10.4103/0301-4738.37595. View

2.
Dittrich S, Tadesse B, Moussy F, Chua A, Zorzet A, Tangden T . Target Product Profile for a Diagnostic Assay to Differentiate between Bacterial and Non-Bacterial Infections and Reduce Antimicrobial Overuse in Resource-Limited Settings: An Expert Consensus. PLoS One. 2016; 11(8):e0161721. PMC: 4999186. DOI: 10.1371/journal.pone.0161721. View

3.
Sarfo B, Hahn A, Schwarz N, Jaeger A, Sarpong N, Marks F . The usefulness of C-reactive protein in predicting malaria parasitemia in a sub-Saharan African region. PLoS One. 2018; 13(8):e0201693. PMC: 6078295. DOI: 10.1371/journal.pone.0201693. View

4.
Sarfo J, Amoadu M, Kordorwu P, Adams A, Gyan T, Osman A . Malaria amongst children under five in sub-Saharan Africa: a scoping review of prevalence, risk factors and preventive interventions. Eur J Med Res. 2023; 28(1):80. PMC: 9936673. DOI: 10.1186/s40001-023-01046-1. View

5.
Chiabi A, Djimafo A, Nguefack S, Mah E, Nguefack Dongmo F, Angwafo 3rd F . Severe malaria in Cameroon: Pattern of disease in children at the Yaounde Gynaeco-Obstetric and Pediatric hospital. J Infect Public Health. 2020; 13(10):1469-1472. DOI: 10.1016/j.jiph.2020.02.038. View