SERUM CREATININE LEVELS AND REACTIVE NITROGEN INTERMEDIATES IN CHILDREN WITH CEREBRAL MALARIA IN PAPUA-NEW-GUINEA

Serum from 41 of 92 children admitted to Madang Hospital, Papua New Gu inea, with cerebral malaria, previously assessed for serum levels of r eactive nitrogen intermediates (RNI: nitrate plus nitrite), were reass essed for creatinine levels on the day of admission. Further analysis of RNI levels on day 21 compared to day 0 was carried out. Children wi th the highest RNI levels on admission, and with the longest duration of coma, did not have elevated creatinine levels. The highest levels o f creatinine occurred among those with the lightest coma and creatinin e levels were similar in those with short (<48 h) and long (>48 h) dur ation of coma. Between days 0 and 31, RNI decreased in 30 of 57 childr en, increased in 23, and did not change in 4. There was a significant relationship between the decrease in RNI relative to the level of RNI on admission and the duration of coma. For children with a coma durati on <48 h (48/57), there was no difference between the numbers showing an increase or a decrease in RNI level, but 6 of the 9 children with c oma duration >48 h showed a decrease in Rh? greater than 50% of the RN I levels on admission. None of these 9 children had elevated creatinin e levels. Elevated RNI levels in severe cases were thus not associated with renal function in these children in Papua New Guinea.