Malaria and haematologic parameters of pupils at different altitudes along the slope of Mount Cameroon: a cross-sectional study

Abstract

BackgroundHaematologic abnormalities are features in Plasmodium falciparum infection, and anaemia is an inevitable outcome. This study examines the influence of malaria status and altitude on haematologic parameters in school-aged pupils.MethodsA cross-sectional study was conducted among 728 school pupils aged between four and 15 years at three different altitudinal ranges along the slope of the Mount Cameroon region. The investigative methods included the use of questionnaire, clinical evaluation and laboratory investigations. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer.ResultsThe prevalence of malaria in the study population was 33.8% and 64.2% (158/246) of these were asymptomatic (AM). Pupils in lowlands had a significantly (P <0.05) prevalence (95% confidence interval, CI) of malaria (60.6%, CI = 54.6–65.9%) than those in middle belt (29.1%, CI = 23.9–34.8%) and highlands (7.7%, CI = 6.1–9.8%), while those in middle belt had significantly higher geometric mean parasite density (475) than those in lowlands (233) and highlands (388). The prevalence of malaria was significantly higher in children that presented with fever (40.4%, CI = 33.8–47.2%) when compared with afebrile subjects (31%, CI = 27–35.2%). Pupils with AM had a higher prevalence of leucopaenia (43.7%, CI = 35.8–51.8%), microcytosis (27.2%, CI = 20.5–34.9%), hypochromasia (27.8%, CI = 21–35.5%) and thrombocytopaenia (14.9%, CI = 8.9–22.8%) when compared with those with clinical malaria (CM). All mean haematological parameters were comparable in pupils with CM and AM, except for the mean white blood cell (WBC) counts. Pupils with AM had significantly lower (P = 0.02) mean WBC counts (5.1 ± 2.5 × 109/L) than those with CM (5.9 ± 2.3 × 109/L). Age, altitude and malaria parasitaemia was of significant influence on several haematological parameters.ConclusionAltitude influenced the distribution and density of malaria parasites and was of confounding influence on the haematologic profiles. These results highlight the insidious effects of AM on the haematologic components.

Malaria, Moderate to Severe Anaemia, and Malarial Anaemia in Children at Presentation to Hospital in the Mount Cameroon Area: A Cross-Sectional Study

“…There are two seasons, the rainy and the dry seasons, which start from mid-March to October and November to mid-March, respectively. The prevalence of malaria parasitaemia in the Mount Cameroon area varies from 60.6%, in lowland altitude, to 7.7% in the highlands [5]. …”

“…Children who participated in the study came from various localities and altitudes. The altitude was classified as lowland (0–167 m asl), middle belt (600–650 m asl), and highland (897–918 m asl) as reported by Kimbi et al [5]. Only children whose parent/guardian signed the informed consent/assent forms following the education on the importance of the study were enrolled.…”

“…However, in order to properly evaluate control measures, regular updates of disease morbidities in public health services and community settings in the country are invaluable. Even though studies have been carried out on severe and uncomplicated malaria in children admitted to hospitals in different parts of the country [2, 3] as well as uncomplicated and asymptomatic malaria in the communities [4] and primary school children [5], there is a dearth of information on malaria-related morbidities at presentation in the general medical outpatient department in the country.…”

Malaria parasitemia and its association with lipid and hematological parameters among malaria-infected patients attending at Metema Hospital, Northwest Ethiopia

“…8 With regard to the association between blood cells and malaria infection, analysis of hematological parameters indicates increased predictive value. 9 In spite of causing complication and malaria pathology, hematological changes such as anemia, thrombocytopenia, and leukocytosis or leukopoenia have been reported but the degree of alterations varies according to the level of malaria endemicity, nutritional status, background hemoglobinopathy, socio-demographic factors, and malaria immunity. 10 The extent of serum lipid and hematological parameters changes during malarial infection and their underlying biological mechanisms in level of parasitemia remain unclear.…”

Comparison of immuno-fluorescence microscopy and optical microscopy after Giemsa staining in the diagnosis of malaria during pregnancy in Buea, Cameroon

“…The low specificity and negative predictive value of FM suggest a high likelihood of false negative results if FM is used. Kimbi et al (2013) also used the FM in Buea, Cameroon to identify malaria in pupils, though they did not compare it to the OM and reported a prevalence rate of 33.4%. In their study, the positive and negative predictive values of the cyscope were 94.1% (95% CI: 87.4% -97.8%) and 95.3% (95% CI: 85.4% -99.2%) respectively.…”