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Association between Sickle Cell Trait and Low Density Parasitaemia in a P. falciparum Malaria Holoendemic Region of Western Kenya

Walter Otieno, Benson B. A. Estambale, Joash R. Aluoch, Stacey M. O. Gondi, José A. Stoute

International Journal of TROPICAL DISEASE & Health · pp. 231–240 · Published 8 Dec 2012

10.9734/IJTDH/2012/1762

Abstract

Aims: The frequency of the mutant gene for sickle cell is widely distributed in the sub-Saharan Africa, the Middle East, and the Indian subcontinent. There is epidemiologic evidence that sickle cell trait confers a survival advantage against malaria and that the selection pressure due to malaria has resulted in high frequencies of the mutant gene in areas of high malaria transmission. We carried out a study to look at the relationship between sickle cell trait, age, haemoglobin level, and malaria parasite density. Methods: We carried out a cross-sectional study between the months of October and December, 2004 in Kombewa Division of Kisumu West District, a P. falciparum malaria holoendemic area with entomological inoculation rates estimated at 31.1 infective bites per person per year. We screened and quantified malaria parasitaemia in participants (age 0 to 45 years n = 342). Haemoglobin electrophoresis was performed on blood from all the participants. Results: In total, 402 participants were screened of which 342 were enrolled. Of these, 280(81.4%) had haemoglobin AA, 60(17.4%) had haemoglobin AS and 2(0.6%) had haemoglobin SS. Those with HbAA and HbAS were included for the analysis bringing the total number to 340 participants. For asymptomatic individuals in the community who displayed no signs of an acute or chronic illness and who were P. falciparum malaria parasite positive; the mean parasite density/µL for HbAS of 4064.0 (95% CI 1858.0 – 6270.0) was significantly lower than that of HbAA 11,067.9 (95% CI 7616.0 – 14520.0) (P = 0.001). Conclusion: The sickle cell carrier status is high (17.4%) in this population and is protective against high density parasitaemia. It is suggested that any malaria intervention strategies should factor in the possibility of sickle cell trait as a confounder to the protective effect of the intervention.

Sickle cell trait asymptomatic parasitaemia P. falciparum malaria.

References (24)

  1. 1 Indicators of Life-Threatening Malaria in African Children [DOI]
  2. 2 Protective effects of the sickle cell gene against malaria morbidity and mortality [DOI]
  3. 3 Sickle Hemoglobin (Hb S) Allele and Sickle Cell Disease: A HuGE Review [DOI]
  4. 4 SUGGESTIONS AS TO QUANTITATIVE MEASUREMENT OF RATES OF EVOLUTION [DOI]
  5. 5 Sickle Cell Trait and the Risk ofPlasmodium falciparumMalaria and Other Childhood Diseases [DOI]
  6. 6 REDUCING THE BURDEN OF ANEMIA IN INFANTS AND YOUNG CHILDREN IN MALARIA-ENDEMIC COUNTRIES OF AFRICA: FROM EVIDENCE TO ACTION [DOI]
  7. 7 An Immune Basis for Malaria Protection by the Sickle Cell Trait [DOI]
  8. 8 Red cell surface changes and erythrophagocytosis in children with severe Plasmodium falciparum anemia [DOI]
  9. 9 Sickle Cell Trait Is Associated with a Delayed Onset of Malaria: Implications for Time‐to‐Event Analysis in Clinical Studies of Malaria [DOI]
  10. 10 Loss of Red Blood Cell–Complement Regulatory Proteins and Increased Levels of Circulating Immune Complexes Are Associated with Severe Malarial Anemia [DOI]
  11. 11 Population Dynamics of Malaria Vectors in Western Kenya Highlands [DOI]
  12. 12 Higher resistance to Plasmodium falciparum infection in patients with homozygous sickle cell disease in western Kenya [DOI]
  13. 13 Complement decay accelerating factor (DAF)/CD55 in cancer [DOI]
  14. 14 Complement activation in experimental human malaria infection [DOI]
  15. 15 Increased deposition of C3b on red cells with low CR1 and CD55 in a malaria-endemic region of western Kenya: Implications for the development of severe anemia [DOI]
  16. 16 Host factors affecting the delay of reappearance of Plasmodium falciparum after radical treatment among a semi-immune population exposed to intense perennial transmission. [DOI]
  17. 17 NOTES ON SICKLE‐CELL POLYMOKPHISM [DOI]
  18. 18 Complement-regulatory proteins in severe malaria: too little or too much of a good thing? [DOI]
  19. 19 BURDEN OF MALARIA AT COMMUNITY LEVEL IN CHILDREN LESS THAN 5 YEARS OF AGE IN TOGO [DOI]
  20. 20 Hereditary red cell disorders and malaria resistance [DOI]
  21. 21 Hb Kenya among Luo Adults and Young Children in Malaria Holoendemic Western Kenya: Screened by High Performance Liquid Chromatography and Confirmed By Polymerase Chain Reaction [DOI]
  22. 22 Resistance to Falciparum Malaria among Adults in Central Sudan [DOI]
  23. 23 Expression of complement receptors and regulatory proteins on alveolar CD4+ lymphocytes from human immunodeficiency virus-1 infected individuals [DOI]
  24. 24 [Plasmodium falciparum or P. malariae parasitemia in carriers of sickle cell trait in various Benin biotypes].

Cited by 12

Sickle Cell Trait (HbAS) is Associated with Increased Expression of Erythrocyte Complement Regulatory Proteins CR1 and CD55 Levels in Children

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