TY - JOUR
T1 - Influence of haemoglobins S and C on predominantly asymptomatic Plasmodium infections in northern Ghana
AU - Danquah, Ina
AU - Ziniel, Peter
AU - Eggelte, Teunis A.
AU - Ehrhardt, Stephan
AU - Mockenhaupt, Frank P.
N1 - Funding Information:
Written informed consent was obtained from the parents, and the study protocol was reviewed and approved by the Ethics Committee of the University for Development Studies, Tamale, and the Regional Ministry of Health, Tamale, Northern Region, Ghana, and the Ethics Committee, Charité - Universitätsmedizin Berlin, Berlin, Germany.
PY - 2010/11
Y1 - 2010/11
N2 - The haemoglobin (Hb) variants HbS and HbC protect against severe malaria. Yet, the influence particularly of HbC on asymptomatic or mild Plasmodium infection is not well established.In a dry season cross-sectional survey among 2108 children aged 0.5-9 years in the Northern Region of Ghana, Plasmodium species and density, as well as Hb, were analysed with respect to Hb genotypes. HbAC occurred in 19.7% and HbAS in 7.4% (HbSC, 0.8%; HbCC, 0.8%; HbSS, 0.3%). Overall, 56% of the children had microscopically visible parasitaemia. By PCR, P. falciparum, P. malariae, and P. ovale were present in 74.5%, 9.7%, and 5.5%, respectively. Febrile parasitaemia was rare (2.8%) but anaemia (Hb < 11. g/dL) frequent (59.3%). Children with HbAA and HbAC showed virtually identical malariometric parameters. In contrast, children with HbAS had significantly less parasitaemia, lower parasite densities, and a higher proportion of submicroscopic P. falciparum infection. Remarkably, in children with HbCC, P. malariae infection occurred in 37.5% (adjusted odds ratio (aOR), 5.8; 95% CI, 1.8-18.8) and P. ovale in 18.8% (aOR, 3.61; 95% CI, 0.97-13.5).In this population with predominantly asymptomatic Plasmodium infection, HbAC shows no discernible effect on malaria-related parameters. Homozygous HbC, in contrast, confers an increased risk of P. malariae infection which conceivably may modulate falciparum malaria.
AB - The haemoglobin (Hb) variants HbS and HbC protect against severe malaria. Yet, the influence particularly of HbC on asymptomatic or mild Plasmodium infection is not well established.In a dry season cross-sectional survey among 2108 children aged 0.5-9 years in the Northern Region of Ghana, Plasmodium species and density, as well as Hb, were analysed with respect to Hb genotypes. HbAC occurred in 19.7% and HbAS in 7.4% (HbSC, 0.8%; HbCC, 0.8%; HbSS, 0.3%). Overall, 56% of the children had microscopically visible parasitaemia. By PCR, P. falciparum, P. malariae, and P. ovale were present in 74.5%, 9.7%, and 5.5%, respectively. Febrile parasitaemia was rare (2.8%) but anaemia (Hb < 11. g/dL) frequent (59.3%). Children with HbAA and HbAC showed virtually identical malariometric parameters. In contrast, children with HbAS had significantly less parasitaemia, lower parasite densities, and a higher proportion of submicroscopic P. falciparum infection. Remarkably, in children with HbCC, P. malariae infection occurred in 37.5% (adjusted odds ratio (aOR), 5.8; 95% CI, 1.8-18.8) and P. ovale in 18.8% (aOR, 3.61; 95% CI, 0.97-13.5).In this population with predominantly asymptomatic Plasmodium infection, HbAC shows no discernible effect on malaria-related parameters. Homozygous HbC, in contrast, confers an increased risk of P. malariae infection which conceivably may modulate falciparum malaria.
KW - Dry season
KW - Ghana
KW - Haemoglobin C
KW - Malaria
KW - Plasmodium malariae
KW - Sickle
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U2 - 10.1016/j.trstmh.2010.08.001
DO - 10.1016/j.trstmh.2010.08.001
M3 - Article
C2 - 20800861
AN - SCOPUS:77957945743
SN - 0035-9203
VL - 104
SP - 713
EP - 719
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
IS - 11
ER -