Abstract:
This was a prospective study conducted at the Moi Teaching and Referral Hospital, Eldoret, Kenya.
Twenty-three children admitted to the hospital with cerebral (CM) and 10 children with non cerebral malaria (NCM) were studied. The aim of the study was to establish and compare levels of
tumour necrosis factor (TNF-a) and transforming growth factor (TGF-b1) in these children. Serum
and cerebrospinal fluid (CSF) cytokine levels were assayed using ELISA kits. In serum, TGF-b1
and TNF-a decreased over 5 days after admission to the hospital in both groups of patients with
CM and NCM. In the CSF of cerebral cases the levels of TNF-a and TGF-b1 were low and inversely
related. Children in deeper coma had lower levels in serum of TGF-b and higher levels of TNF-a
than those in lighter levels of coma. The serum TNF-a levels in CM children were the same irre spective of the duration of illness before admission, but children with NCM who had been sick for
a shorter duration before admission tended to have higher serum levels of TNF-a and higher levels
of TGF-b than those with a longer duration of illness before admission. In conclusion, this study
shows that TNF-a and TGF-b1 may not be useful in predicting the outcome for CM. They may,
however, be useful in detecting children at risk of developing deep coma. TNF-a and TGF-b levels
were inversely related both in serum and CSF.
