Antierythropoietin Antibody Production Is Not Associated with Malaria and Malaria-Related Anaemia in Humans

Abstract

Introduction. The pathophysiology of malaria-related anaemia is not fully understood although increased destruction of parasitized and nonparasitized erythrocytes, as well as inadequate erythropoiesis, has been proposed. Circulating antierythropoietin (anti-EPO) antibodies have also been implicated in malaria and malaria-related anaemia in mice. However, studies on this association have not been investigated in humans. This study therefore determined the prevalence of anti-EPO antibody production and assessed its association with malaria and malaria-related anaemia in humans.Methods. A total of 86 children aged 1-10 years (57 children with malaria serving as the case group and 29 healthy children serving as control), all residents of Duayaw Nkwanta, Ghana, were recruited for this case-control study. Venous blood was collected for thick and thin films for malaria microscopy, full blood count by automated haematology analyzer, and antierythropoietin antibody and erythropoietin estimation by sandwich ELISA method.Results. Out of the 86 participants recruited, only 3 (3.5%) were positive for anti-EPO antibody; 2.3% of the case group; and 1.2% of the control group. There was no association between the cases and the controls in the production of anti-EPO antibodies. Erythropoietin concentration was significantly higher in malaria-related anaemic subjects (p=0.032).Conclusion. Antierythropoietin antibodies are not associated with malaria infection and malaria-related anaemia in humans. Erythropoietin concentration is associated with malaria-related anaemia.

A multicenter study of the prevalence and risk factors of malaria and anemia among pregnant women at first antenatal care visit in Ghana

“…Regression analysis from our study, revealed that malaria increases the risk of anemia by two-folds among the population. Other studies have also reported increased risk of anemia with malaria among pregnant women in Ghana and elsewhere [ 35 , 37 , 53 – 55 ] This finding could be linked to the intricate relationship between malaria and anemia such as malaria-induced destruction of non-parasitized and parasitized red cells, impaired erythropoiesis and delayed reticulocyte response due to suppression of the normal erythropoietin response during periods of tissue hypoxia [ 14 – 16 ]. Nonetheless, it is worthy of note that, malaria contributed only 4.5%, 0.3% and 0.3% to the prevalence of mild, moderate and severe anemia, respectively, suggesting that the presence of other factors, as indicated in this study, also play important roles in anemia in pregnancy.…”

“…Other factors such as socio-demographic and economic factors such as place of residence and educational level also play important roles [ 13 ]. The relationship between malaria and anemia is in the role played by malaria in the depletion of non-parasitized erythrocytes, immune destruction of parasitized red cells, and impaired erythropoiesis as a result of bone marrow dysfunction [ 14 – 16 ]. Malaria accounts for an estimated 3–15% of anemia and 25% of severe anemia in pregnant women from malaria-endemic countries [ 9 ].…”

Point prevalence of asymptomatic Plasmodium infection and the comparison of microscopy, rapid diagnostic test and nested PCR for the diagnosis of asymptomatic malaria among children under 5 years in Ghana

“…Malaria is a pervasive parasitic disease in the tropical and subtropical regions which is mostly prevalent in sub-Saharan Africa, Asia, and Latin America [1]. Currently, the World Health Organization (WHO) estimates 219 million cases and 435,000 malaria-related deaths globally [2].…”

Malaria asociada al embarazo: revisión narrativa

“…En líneas generales, las infecciones palúdicas producen del 3 % al 15 % de los casos de anemia, la cual resulta de la depleción de eritrocitos no parasitados con liberación de merozoitos, destrucción inmunológica de eritrocitos parasitados, pérdida de la deformabilidad del glóbulo rojo, y/o de la disfunción de la médula ósea que genera un proceso de eritropoyesis inefectiva. Pero, de estos, el 25 % de los mismos constituyen casos de anemia grave en las embarazadas que habitan en regiones endémicas, producto del secuestro eritrocitario placentario, hemólisis, eritropoyesis inefectiva, inhibición de la liberación de reticulocitos, destrucción prematura de los eritrocitos durante su fase de maduración en la médula ósea, e/o hiperesplenismo (2,14,35,(52)(53)(54)(55)(56). La anemia grave se define como valores de hemoglobina menores a 7 g/dl y esta puede ocasionarle a la gestante con infección malárica una alta morbimortalidad maternofetal y complicaciones como fetos de bajo peso al nacer, parto pretérmino y muerte por hemorragia posparto.…”