404
Y. A. Abdulhameed et al.
26.2.1 Subjects and Plan of the Study
Consecutive adult male patients presenting to Murtala Mohammed Specialist Hospital, Kano, Nigeria with acute ailments and fever during August–November 2017
were evaluated by taking clinical history and examination. Blood samples for tests
were collected from patients considered likely to have malaria for subsequent
malarial smear microscopy, rapid diagnostic tests (RDT), haematocrit level and for
haemoglobin genotype. These tests were conducted later, but the physical data acquisition was conducted immediately in a cool and quiet place as detailed in Sect. 26.2.2
on patients considered likely to have malaria. Where the results of the medical tests
subsequently confirmed presence of malaria, absence of anaemia (low haematocrit)
and AA genotype, patients were retained in the study and categorized as febrile
malaria (FM) (37) or non-febrile malaria (NFM) (10). The results of 20 patients who
did not fit the criteria were discarded, regardless of malarial status, because anaemia
and/or abnormal haemoglobin genotype are known to affect blood flow dynamics and
RBC morphology, and consequently the physical parameters being studied. A control
group of 51 healthy non-malaria (NM) male subjects was also recruited.
For all subjects, the inclusion criteria included: (i) informed consent for participation in the study, under a protocol approved by the Ethical Committees of both
the Kano State Ministry of Health, Nigeria and Bayero University Kano, Nigeria;
(ii) absence of overt alternative/superadded cause of febrile illness; (iii) absence of
significant co-morbidity/complications known to affect the test, e.g. hypertension
or peripheral vascular disease; (iv) absence of sickle cell anaemia in a blood group
genotype test; and (v) having the AA genotype blood group.
For the FM and NFM groups, additional inclusion criteria were: (vi) presence
of malarial parasites in blood film microscopy; and (vii) a positive malarial Rapid
Diagnostic Test (RDT). The difference in the inclusion criteria for febrile malaria
and non-febrile malaria group was body temperature. Malaria patients presenting
with a core temperature above 38.0
◦ C were defined as FM, while those with lower
temperatures were defined as NFM.
For the NM group, the additional inclusion criteria were: (vi) no acute febrile
illness (temperature < 37.0
◦ C); (vii) absence of malarial parasites in blood film
microscopy; and (viii) a negative malarial RDT.
In the FM group, 30% of the patients had taken antimalarial and antipyretic drugs
before presenting; 40% had taken antipyretic drugs only, and 30% had not taken any
drugs. In the NFM group, all patients had taken antimalarial and/or antipyretic drugs
for at most 3 days.
26.2.2 Data Acquisition
The measurements were all made between 09:00 and 18:00 in a quiet air-conditioned
room, with a controlled ambient temperature and constant low illumination.
Y. A. Abdulhameed et al.
26.2.1 Subjects and Plan of the Study
Consecutive adult male patients presenting to Murtala Mohammed Specialist Hospital, Kano, Nigeria with acute ailments and fever during August–November 2017
were evaluated by taking clinical history and examination. Blood samples for tests
were collected from patients considered likely to have malaria for subsequent
malarial smear microscopy, rapid diagnostic tests (RDT), haematocrit level and for
haemoglobin genotype. These tests were conducted later, but the physical data acquisition was conducted immediately in a cool and quiet place as detailed in Sect. 26.2.2
on patients considered likely to have malaria. Where the results of the medical tests
subsequently confirmed presence of malaria, absence of anaemia (low haematocrit)
and AA genotype, patients were retained in the study and categorized as febrile
malaria (FM) (37) or non-febrile malaria (NFM) (10). The results of 20 patients who
did not fit the criteria were discarded, regardless of malarial status, because anaemia
and/or abnormal haemoglobin genotype are known to affect blood flow dynamics and
RBC morphology, and consequently the physical parameters being studied. A control
group of 51 healthy non-malaria (NM) male subjects was also recruited.
For all subjects, the inclusion criteria included: (i) informed consent for participation in the study, under a protocol approved by the Ethical Committees of both
the Kano State Ministry of Health, Nigeria and Bayero University Kano, Nigeria;
(ii) absence of overt alternative/superadded cause of febrile illness; (iii) absence of
significant co-morbidity/complications known to affect the test, e.g. hypertension
or peripheral vascular disease; (iv) absence of sickle cell anaemia in a blood group
genotype test; and (v) having the AA genotype blood group.
For the FM and NFM groups, additional inclusion criteria were: (vi) presence
of malarial parasites in blood film microscopy; and (vii) a positive malarial Rapid
Diagnostic Test (RDT). The difference in the inclusion criteria for febrile malaria
and non-febrile malaria group was body temperature. Malaria patients presenting
with a core temperature above 38.0
◦ C were defined as FM, while those with lower
temperatures were defined as NFM.
For the NM group, the additional inclusion criteria were: (vi) no acute febrile
illness (temperature < 37.0
◦ C); (vii) absence of malarial parasites in blood film
microscopy; and (viii) a negative malarial RDT.
In the FM group, 30% of the patients had taken antimalarial and antipyretic drugs
before presenting; 40% had taken antipyretic drugs only, and 30% had not taken any
drugs. In the NFM group, all patients had taken antimalarial and/or antipyretic drugs
for at most 3 days.
26.2.2 Data Acquisition
The measurements were all made between 09:00 and 18:00 in a quiet air-conditioned
room, with a controlled ambient temperature and constant low illumination.