Anaemia and malaria in Yanomami communities with differing access to healthcare

Abstract

Inequitable access to healthcare has a profound impact on the health of marginalised groups that typically suffer an excess burden of infectious disease morbidity and mortality. The Yanomami are traditionally semi-nomadic people living in widely dispersed communities in Amazonian Venezuela and Brazil. Only communities living in the vicinity of a health post have relatively constant access to healthcare. To monitor the improvement in the development of Yanomami healthcare a cross-sectional survey of 183 individuals was conducted to investigate malaria and anaemia prevalence in communities with constant and intermittent access to healthcare. Demographic and clinical data were collected. Malaria was diagnosed by microscopy and haemoglobin concentration by HemoCue. Prevalence of malaria, anaemia, splenomegaly, fever and diarrhoea were all significantly higher in communities with intermittent access to healthcare (anaemia 80.8% vs. 53.6%, P<0.001; malaria 18.2% vs. 6.0%, P=0.013; splenomegaly 85.4% vs.12.5%, P<0.001; fever 50.5% vs. 28.6%, P=0.003; diarrhoea 30.3% vs.10.7% P=0.001). Haemoglobin level (10.0 g/dl vs. 11.5 g/dl) was significantly associated with access to healthcare when controlling for age, sex, malaria and splenomegaly (P=0.01). These findings indicate a heavy burden of anaemia in both areas and the need for interventions against anaemia and malaria, along with more frequent medical visits to remote areas.

A longitudinal study on anaemia in children with Plasmodium falciparuminfection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers

“…[30] and Grenfell et al . [31] who reported fever not to be associated with haemoglobin concentration, our findings revealed a significant negative correlation (r = − 0.18, P < 0.01) between haemoglobin concentration and temperature and a direct relationship between temperature and parasitaemia with the fever rate decreasing with increased age. The observed negative association between temperature and haemoglobin may be due to certain immunologic responses such as the secretion of high levels of tumour necrosis factor-α (TNF-α), a potent pyrogen.…”

Naturally acquired immune responses to malaria vaccine candidate antigens MSP3 and GLURP in Guahibo and Piaroa indigenous communities of the Venezuelan Amazon

“…Individuals with a blood smear positive for malaria were treated according to the national guidelines ( P. falciparum: artesunate, mefloquine, and primaquine. P. vivax: chloroquine, primaquine) [13]. …”

Aboriginal Populations and Their Neglected Tropical Diseases

“…Efforts have been undertaken in some areas to provide mass treatments with azithromycin [39]. Finally, it has been noted that the Yanomami suffer from high infection rates of malaria, as well as anemia [40]. The contribution of hookworm or other parasitic infections to anemia among the Yanomami has not been widely studied.…”