Association between Sickle Cell Trait and Low Density Parasitaemia in a P. falciparum Malaria Holoendemic Region of Western Kenya
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Date
2012Author
Otieno, Walter
Estambale, Benson
Aluoch, Joash R
Gondi, Stacey MO
Stoute, José A
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
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/L 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
Citation
International Journal of TROPICAL DISEASE & Health 2(4): 231-240, 2012Publisher
University of Nairobi Institute of Tropical & Infectious Diseases (UNITID), Kenya US Army Medical Research Unit, Kenya Medical Research Institute, Kisumu, Kenya Maseno University School of Medicine, Maseno, Kenya Department of Medicine, Penn State University College of Medicine, Pennsylvania, USA
Collections
- Faculty of Health Sciences (FHS) [10377]