The incidence of malaria and the comparison of hematological and biochemical indices of Plasmodium falciparum‐parasitemic and aparasitemic sickle cell disease (SCD) patients

Abstract

Hemolytic anemia is common in sickle cell disease (SCD), but the course and extent differ, depending on genetic, epigenetic, and environmental factors. In the malaria-endemic tropical environment, some vulnerable subjects would be infected and the impact of infection would vary. Therefore, this study was to find malaria incidence and the associated changes in some laboratory indices in 330 SCD subjects. Following blood smear preparation for falciparum detection, hematological and biochemical indices were measured for a comparison of parasitemic and age-matched, genotype-matched, and sex-matched nonparasitemics. For sixty-nine parasitemics, constituting about 21% of all subjects studied, and sixty-six matched nonparasitemics, hematological indices (hemoglobin, white-cell count, red-cell count, mean cellular volume, reticulocyte count, and HbF) as well as biochemical indices (LDH, total bilirubin, AST, and ALT) were determined. For all quantities, except the reticulocyte count (12.3% ± 12.4% for parasitemics and 23.6% ± 17.7% for nonparasitemics), no statistically significant differences were observed. Classification of both cohorts according to their genotypes showed some intergenotypic differences for hemoglobin and WBC counts. Mathematical modeling of the reticulocyte counts shows the distribution in the parasitemics followed an exponential pattern, while the nonparasitemic showed a polynomial distribution, with each model characterized by an equation of best fit. The study has shown about 21% incidence of parasitemia. All differences in the indices can be seen as normal variations, unattributable to the malaria infection. However, the lower reticulocyte count in the parasitemic is a reflection of lowered erythropoietic activity because of the infection.

A randomized trial of artesunate-amodiaquine versus artemether-lumefantrine in Ghanaian paediatric sickle cell and non-sickle cell disease patients with acute uncomplicated malaria

“…The corresponding profiles for the SCD subjects are also similar to reported values for SCD subjects [58]. …”

Whole-Blood Transcriptional Signatures Composed of Erythropoietic and NRF2-Regulated Genes Differ Between Cerebral Malaria and Severe Malarial Anemia

“…Both M111.0 expression and leukocyte count, but not IP-10, negatively predicted reticulocyte-specific expression. Consistent with chronic, compensated hemolysis seen in sickle cell anemia [29], HbSS status predicted higher reticulocyte-gene expression relative to CM after controlling for other factors.…”

Haematological indices and electrolyte status in sickle cell disease at rural hospital of central Maharashtra.

“…[6] The mean total white blood cell count (WBC) in this study were similar to other earlier studies. [2,6,7] Studies reported rise in TLC in patients of SCD, as compared to control groups. But in our study, it was not statistically significant (>0.05).…”

“…Consequently, patients with SCD suffer repeated vasoocclusive events characterized by ischemia-reperfusion injury and inflammation, in which red blood cells (RBCs) and white blood cells (WBCs) play a key role. [2] Although red cell sickling is more prominent during crisis, continuous sickling does occur at a lower rate in the steady state. Hence, a certain proportion of sickled cells are always present in the circulation of SCA patients even in steady state.…”