Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Transactions of the Royal Society of Tropical Medicine and Hygiene |
| Vol/bind | 93 |
| Udgave nummer | 6 |
| Sider (fra-til) | 623-7 |
| Antal sider | 4 |
| ISSN | 0035-9203 |
| Status | Udgivet - 1999 |
Bibliografisk note
Keywords: Adolescent; Anemia; Child; Child, Preschool; Cohort Studies; Erythrocyte Indices; Erythropoiesis; Female; Follow-Up Studies; Hemoglobins; Humans; Malaria, Falciparum; MaleCitationsformater
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Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren. / Kurtzhals, J A; Addae, M M; Akanmori, B D; Dunyo, S; Koram, K A; Appawu, M A; Nkrumah, F K; Hviid, L.
I: Transactions of the Royal Society of Tropical Medicine and Hygiene, Bind 93, Nr. 6, 1999, s. 623-7.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren
AU - Kurtzhals, J A
AU - Addae, M M
AU - Akanmori, B D
AU - Dunyo, S
AU - Koram, K A
AU - Appawu, M A
AU - Nkrumah, F K
AU - Hviid, L
N1 - Keywords: Adolescent; Anemia; Child; Child, Preschool; Cohort Studies; Erythrocyte Indices; Erythropoiesis; Female; Follow-Up Studies; Hemoglobins; Humans; Malaria, Falciparum; Male
PY - 1999
Y1 - 1999
N2 - A cohort of 250 Ghanaian schoolchildren aged 5-15 years was followed clinically and parasitologically for 4 months in 1997/98 in order to study the effect of asymptomatic Plasmodium falciparum infections on haematological indices and bone-marrow responses. Of the 250 children 65 met the predefined study criteria. Thus, 14 children were parasite-free throughout (group 1), 44 had P. falciparum in all blood samples collected but no symptoms of malaria (group 2), and 7 had 1 malaria attack during the study period (group 3). At the end of the study the mean haemoglobin (Hb) level in group 1 was 123 g/L, significantly higher than the value of 114 g/L in groups 2 and 3 (P < 0.02, adjusted for age and splenomegaly). The low Hb in group 2 was associated with subnormal plasma iron. Low Hb was associated with elevated erythropoietin (EPO) levels, and there was a positive correlation between EPO and reticulocyte counts. However, the reticulocyte response to EPO was more pronounced in uninfected than in infected children, suggesting a partial interference with erythropoiesis in asymptomatic infections. Children with asymptomatic infections had significantly higher plasma levels of tumour necrosis factor than uninfected children (geometric means 50 ng/L and 27 ng/L, respectively, P < 0.001) and this cytokine may contribute to bone-marrow suppression and disturbed iron metabolism. We suggest that asymptomatic malaria leads to a homeostatic imbalance in which erythrocyte loss due to parasite replication is only partially compensated for by increased erythropoiesis. The consequences of the reduced Hb levels on the development and cognitive abilities of children with asymptomatic infections, and the risk of precipitation of iron deficiency, deserve further study and should be considered in malaria control programmes that aim at reducing morbidity rather than transmission.
AB - A cohort of 250 Ghanaian schoolchildren aged 5-15 years was followed clinically and parasitologically for 4 months in 1997/98 in order to study the effect of asymptomatic Plasmodium falciparum infections on haematological indices and bone-marrow responses. Of the 250 children 65 met the predefined study criteria. Thus, 14 children were parasite-free throughout (group 1), 44 had P. falciparum in all blood samples collected but no symptoms of malaria (group 2), and 7 had 1 malaria attack during the study period (group 3). At the end of the study the mean haemoglobin (Hb) level in group 1 was 123 g/L, significantly higher than the value of 114 g/L in groups 2 and 3 (P < 0.02, adjusted for age and splenomegaly). The low Hb in group 2 was associated with subnormal plasma iron. Low Hb was associated with elevated erythropoietin (EPO) levels, and there was a positive correlation between EPO and reticulocyte counts. However, the reticulocyte response to EPO was more pronounced in uninfected than in infected children, suggesting a partial interference with erythropoiesis in asymptomatic infections. Children with asymptomatic infections had significantly higher plasma levels of tumour necrosis factor than uninfected children (geometric means 50 ng/L and 27 ng/L, respectively, P < 0.001) and this cytokine may contribute to bone-marrow suppression and disturbed iron metabolism. We suggest that asymptomatic malaria leads to a homeostatic imbalance in which erythrocyte loss due to parasite replication is only partially compensated for by increased erythropoiesis. The consequences of the reduced Hb levels on the development and cognitive abilities of children with asymptomatic infections, and the risk of precipitation of iron deficiency, deserve further study and should be considered in malaria control programmes that aim at reducing morbidity rather than transmission.
M3 - Journal article
C2 - 10717750
VL - 93
SP - 623
EP - 627
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
SN - 0035-9203
IS - 6
ER -