Title

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.

Link to Full Text

Share

COinS