An assessment of iron status was made on 96 pregnant women and 29 non-pregnant, non-lactating menstruating women of comparable age group as controls. Anaemia (haemoglobin < 110 g/l) was present in 84.4% of the pregnant women and in 48.3% of the control group. Iron deficiency (serum ferritin < 12.0 micrograms/l) was present in 51.1% of the pregnant group and 37.9% of the control group. Prevalence of anaemia with iron deficiency was 54.7% in anaemic pregnant women. Serum ferritin correlated significantly with low haemoglobin (P < 0.05). Median serum ferritin declined progressively until 31 weeks of gestation. Preliminary studies on their dietetics showed that low animal protein consumption and poor dietary iron bioavailability were associated with anaemia.

We describe the diversity of Plasmodium falciparum populations in western Uganda and assess the role that asymptomatic malaria carriers with sickle cell trait (HbAS) may be playing on the Plasmodium population structure. We genotyped P. falciparum in 291 samples using merozoite surface protein (MSP) 1 and 2 loci. Extensive genetic diversity was detected among symptomatic children in Mbarara (20 MSP1 alleles; 31 MSP2 alleles) and Kagando, Kasese (19 MSP1 alleles; 30 MSP2 alleles). Multiplicity of infection (MOI) was significantly higher in Kagando, Kasese than in Mbarara, with 2.7 and 2.1 genotypes/PCR positive sample with MSP2 marker, respectively. Similar strains were circulating in the two sites; however, a few strains specific to individual sites were observed. Prevalence of HbAS was 36% (12/33) among asymptomatic children in Kisinga sub-county, Kasese. In asymptomatic children, MOI was age-dependent and higher in HbAS carriers than HbAA, suggesting that HbAS carriers harbour a wider range of P. falciparum genotypes. Sickle cell trait may influence rapid acquisition of premunition by creating a reservoir of variant parasite strains in the host. The high level of genetic diversity demonstrated here shows that even in areas with low or seasonal transmission, high levels of parasite polymorphism can occur.

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