Anaemia in young Primigravidae in the guinea savanna of Nigeria: sickle-cell trait gives partial protection against malaria

Fleming, A. F.; Harrison, K. A.; Briggs, N. D.; Attai, E. D. E.; Ghatoura, G. B. S.; Akintunde, EA; Shah, Nita

doi:10.1080/00034983.1984.11811837

Cited by 27 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to women with HbAA, the prevalence of peripheral P. falciparum parasitaemia was similar in women with HbAS among Nigerian primigravidae 69 and Gabonese primi- and secundigravidae, 70 and significantly higher in Ugandan women of all gravidities (Table S4). 71 In two studies in Ghana there was no association between HbS, HbC, or α-thalassaemia and P. falciparum prevalence.…”

Section: Resultsmentioning

confidence: 97%

Haemoglobinopathies and the clinical epidemiology of malaria: a systematic review and meta-analysis

Taylor

Parobek

Fairhurst

2012

The Lancet Infectious Diseases

279

267

View full text Add to dashboard Cite

SUMMARY Background Haemoglobinopathies variously reduce the risk of developing malaria syndromes. Quantifying these relationships may strengthen the foundation for translational studies of malaria pathogenesis and immunity. Methods The databases of MEDLINE and Embase (1950 – September 9, 2011) were searched to identify studies that estimated the risk of malaria in patients with and without haemoglobinopathies. Additional studies were identified from reference lists. Included outcomes were Plasmodium falciparum-related outcomes of severe malaria, uncomplicated malaria, asymptomatic parasitaemia, or pregnancy-associated malaria, and P. vivax malaria. Two independent reviewers identified studies, assessed their quality, and extracted data; data were meta-analyzed when outcomes were reported in more than one study. Findings Of 62 identified studies, 44 reported on HbAS, 19 on HbAC and HbCC, and 18 on α-thalassaemia. Case-control studies showed a decreased risk of severe malaria for HbAS (summary Odds Ratio [OR] 0.09; 95% confidence interval [CI] 0.06 – 0.12), HbCC (summary OR 0.27; 95% CI 0.11 – 0.63), homozygous α-thalassaemia (summary OR 0.63; 95% CI 0.48 – 0.83), HbAC (summary OR 0.83; 95% CI 0.74 – 0.92), and heterozygous α-thalassaemia (summary OR 0.83; 95% CI 0.74 – 0.92). Only HbAS was consistently associated with protection from uncomplicated malaria (summary Incidence Rate Ratio 0.69; 95% CI 0.61 – 0.79); none demonstrated protection from asymptomatic parasitaemia. There was a paucity of clinical studies investigating β-thalassaemia, HbE, P. vivax malaria, and pregnancy-associated malaria. Interpretation Protection from severe malaria syndromes is significant for HbAS, HbCC, HbAC, and homozygous and heterozygous α-thalassaemia, but these haemoglobinopathies differ substantially in the degrees of protection. Protection from uncomplicated malaria and asymptomatic parasitaemia is mild or absent. By attenuating the severity of malaria, haemoglobinopathies serve as a model for investigating the mechanisms of malaria pathogenesis and immunity.

show abstract

Section: Resultsmentioning

confidence: 97%

Haemoglobinopathies and the clinical epidemiology of malaria: a systematic review and meta-analysis

Taylor

Parobek

Fairhurst

2012

The Lancet Infectious Diseases

279

267

View full text Add to dashboard Cite

show abstract

“…If this is the correct explanation then our observation must reflect a significant underestimate of the true benefits of maternal HbAS on pregnancy outcome 26 . Few studies have addressed this question directly and while none have found convincing evidence to support it 26–29 , most have been too small to provide definitive conclusions. An alternative explanation is that our findings result from malaria resistance in the fetus.…”

Section: Discussionmentioning

confidence: 99%

The indirect health effects of malaria estimated from health advantages of the sickle cell trait

et al. 2019

View full text Add to dashboard Cite

Most estimates of the burden of malaria are based on its direct impacts; however, its true burden is likely to be greater because of its wider effects on overall health. Here we estimate the indirect impact of malaria on children’s health in a case-control study, using the sickle cell trait (HbAS), a condition associated with a high degree of specific malaria resistance, as a proxy indicator for an effective intervention. We estimate the odds ratios for HbAS among cases (all children admitted to Kilifi County Hospital during 2000–2004) versus community controls. As expected, HbAS protects strongly against malaria admissions (aOR 0.26; 95%CI 0.22–0.31), but it also protects against other syndromes, including neonatal conditions (aOR 0.79; 0.67–0.93), bacteraemia (aOR 0.69; 0.54–0.88) and severe malnutrition (aOR 0.67; 0.55–0.83). The wider health impacts of malaria should be considered when estimating the potential added benefits of effective malaria interventions.

show abstract

“…in Nigeria. FLEMING & HARRISON (1984) found that in pri&gravidae, whose immunity to &alar& was suppressed, parasite densities were lower in women in the ginotype AS than in those with the genotype AA. AS women also had lower malaria antibodv levels than those with the genotype AA (CORNILLE-BRAGGER et al, 1979), perhaps because they were exposed to less antigenic stimulation.…”

Section: Discussionmentioning

confidence: 99%

The response to iron supplementation of pregnant women with the haemoglobin genotype AA or AS

Menéndez

Todd

Alonso

et al. 1995

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

The influence of haemoglobin genotype on the response to iron supplementation was studied in a randomized, double blind, placebo-controlled trial involving 497 multigravid pregnant women from a rural area of The Gambia. Women were randomly allocated to receive either oral iron (60mg elemental iron per day) or placebo. At 36 weeks of pregnancy, women who had received oral iron during pregnancy had higher mean haemoglobin, packed cell volume, plasma iron and ferritin levels than did women who received placebo. Iron sup lementation creases in the pat IR of pre ed cell volume (P E nant women with the AA haemoglobin genotype also resulted in in-V) and haemoglobin level measured after delivery, and in the birth weight of the infant. However, in AS women PCV and haemoglobin level at delivery were lower in the supplemented group and supplementation was also associated with reduced birth weights. In malaria endemic areas, pregnant women with the haemoglobin genotype AS may not benefit from iron supplementation during pregnancy.

show abstract

Anaemia in young Primigravidae in the guinea savanna of Nigeria: sickle-cell trait gives partial protection against malaria

Cited by 27 publications

References 12 publications

Haemoglobinopathies and the clinical epidemiology of malaria: a systematic review and meta-analysis

Haemoglobinopathies and the clinical epidemiology of malaria: a systematic review and meta-analysis

The indirect health effects of malaria estimated from health advantages of the sickle cell trait

The response to iron supplementation of pregnant women with the haemoglobin genotype AA or AS

Contact Info

Product

Resources

About