The rôle of malaria, folic acid deficiency and haemoglobin as in pregnancy at Mulago Hospital

Hamilton, P. J. S.; Gebbie, Donald A. M.; Wilks, N. E.; Lothe, F

doi:10.1016/0035-9203(72)90305-7

Cited by 50 publications

(25 citation statements)

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“…71 In two studies in Ghana there was no association between HbS, HbC, or α-thalassaemia and P. falciparum prevalence. 72 In one study in Papua New Guinea that assessed birth outcomes, α-thalassaemia was not associated with placental malaria, birth weight, placental parasite density, maternal peripheral parasitaemia, or maternal anaemia.…”

Section: Resultsmentioning

confidence: 95%

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

Taylor

Parobek

Fairhurst

2012

The Lancet Infectious Diseases

279

267

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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.

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Section: Resultsmentioning

confidence: 95%

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

Taylor

Parobek

Fairhurst

2012

The Lancet Infectious Diseases

279

267

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“…b, Excess risk of low birth weight (LBW) (% LBW in controls − % LBW in drug group). Data from 10 trials comparing antimalarial drug use to control either placebo or no drug controls 36,[44][45][46][47][48][49][50][51][52] were analyzed. Trials were not included if they compared multiple drugs with no inactive control [53][54][55] or could not be matched to entomologic data.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Malaria Transmission Intensity on Neonatal Mortality in Endemic Areas

Ross

Smith

2006

The American Journal of Tropical Medicine and Hygiene

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Abstract.Estimates of the impact of Plasmodium falciparum infections during pregnancy on neonatal mortality have not taken into account how this varies with the level of malaria endemicity and thus do not indicate the possible effects of malaria control strategies that reduce transmission. We now review the relevant literature, and propose a mathematical model for the association between P. falciparum transmission and neonatal death. The excess risk of neonatal mortality in malaria-endemic areas appears to be insensitive to the intensity of P. falciparum transmission over a wide range of endemicity. Moderate reductions in the overall level of malaria transmission in endemic areas are therefore unlikely to significantly reduce neonatal mortality. The magnitude of the excess risk is very uncertain because existing estimates are heavily dependent on the questionable assumption that the effects are mediated by birth weight. Accurate prediction of the impact of malaria control measures targeted at pregnant women requires direct estimates of malariaattributable neonatal mortality rates.

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“…Hamilton et coll. [132] ont rapporté de faibles taux d'infestation chez les femmes enceintes consommant un régime alimentaire riche en folates. Les principales préoccupations de santé publique consistent cependant à savoir si une supplémentation en folates accroît la prolifération des parasites palustres et aggrave l'évo-lution d'un paludisme par son interaction avec les antipaludéens.…”

Section: Folatesunclassified

Prise en charge du paludisme pédiatrique: rôle des interventions nutritionnelles

Osei

Hamer

2008

Ann Nestlé [Fr]

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Le paludisme est la principale cause de morbidité et de mortalité chez l’enfant, particulièrement en Afrique sub-saharienne. Malgré des progrès substantiels du traitement du paludisme pédiatrique au moyen de polythérapies basées sur l’artémisinine, de nombreux obstacles s’opposent encore à la mise en œuvre efficace de ces nouvelles options thérapeutiques très efficaces. De même, des moyens efficaces sont disponibles pour la prévention du paludisme chez l’enfant, mais leur extension afin qu’ils influencent nettement la morbidité et la mortalité d’origine palustre a confronté les organismes de santé publique à d’importantes difficultés. Le statut nutritionnel de l’hôte influence l’acquisition et la sévérité potentielle d’un paludisme. Des données substantielles montrent que le paludisme contribue à une altération de la croissance staturo-pondérale chez l’enfant, mais l’impact de la sous-nutrition sur le paludisme est complexe. Des données de plus en plus nombreuses montrent qu’une supplémentation en certains micronutriments peut jouer un rôle capital dans la prévention du paludisme chez les jeunes enfants. Des interventions au moyen de micronutriments tels le zinc ou la vitamine A peuvent contribuer à réduire la charge pathologique due au paludisme, tandis que d’autres, telles une supplémentation en fer, peuvent exacerber cette maladie. Des différences portant sur la conception et la qualité des études, l’intensité de la transmission du paludisme et d’autres caractéristiques des centres d’études compliquent l’interprétation du nombre limité d’études ayant évalué l’influence de micronutriments spécifiques dans le traitement et la prévention du paludisme. Un seul essai a évalué l’administration de zinc à titre d’appoint dans le traitement du paludisme et n’a démontré aucun bénéfice de ce métal dans ce rôle. Le présent article analyse la prise en charge clinique du paludisme chez l’enfant, les interactions entre cette parasitose et le statut nutritionnel et le rôle potentiel d’une supplémentation en micronutriments pour la prévention d’épisodes cliniques de paludisme chez les jeunes enfants, en déterminant plus particulièrement si chacun des suppléments nutritionnels améliore ou aggrave l’évolution de cette maladie.

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The rôle of malaria, folic acid deficiency and haemoglobin as in pregnancy at Mulago Hospital

Cited by 50 publications

References 4 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 Effect of Malaria Transmission Intensity on Neonatal Mortality in Endemic Areas

Prise en charge du paludisme pédiatrique: rôle des interventions nutritionnelles

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