Plasma angiopoietin-2 is associated with age-related deficits in cognitive sub-scales in Ugandan children following severe malaria

Document Type

Article

Department

Paediatrics and Child Health (East Africa)

Abstract

Background: Elevated angiopoietin-2 (Angpt-2) concentrations are associated with worse overall neurocognitive function in severe malaria survivors, but the specifc domains afected have not been elucidated.

Methods: Ugandan children with severe malaria underwent neurocognitive evaluation a week after hospital discharge and at 6, 12 and 24 months follow-up. The relationship between Angpt-2 concentrations and age-adjusted, cognitive sub-scale z-scores over time were evaluated using linear mixed efects models, adjusting for disease severity (coma, acute kidney injury, number of seizures in hospital) and sociodemographic factors (age, gender, height-for-age z-score, socio-economic status, enrichment in the home environment, parental education, and any preschool education of the child). The Mullen Scales of Early Learning was used in children <5 years and the Kaufman Assessment Battery for Children 2nd edition was used in children ≥5 years of age. Angpt-2 levels were measured on admission plasma samples by enzyme-linked immunosorbent assay. Adjustment for multiple comparisons was conducted using the Benjamini–Hochberg Procedure of False Discovery Rate.

Results: Increased admission Angpt-2 concentration was associated with worse outcomes in all domains (fne and gross motor, visual reception, receptive and expressive language) in children <5 years of age at the time of severe malaria episode, and worse simultaneous processing and learning in children <5 years of age at the time of severe malaria who were tested when ≥5 years of age. No association was seen between Angpt-2 levels and cognitive outcomes in children ≥5 years at the time of severe malaria episode, but numbers of children and testing time points were lower for children ≥5 years at the time of severe malaria episode. Conclusion: Elevated Angpt-2 concentration in children with severe malaria is associated with worse outcomes in multiple neurocognitive domains. The relationship between Angpt-2 and worse cognition is evident in children <5 years of age at the time of severe malaria presentation and in selected domains in older years

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

BioMed Central

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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