Hemoglobin concentration in children in a malaria holoendemic area is determined by cumulated Plasmodium falciparum parasite densities


Ekvall, H; Premji, Z; Bennett, S; Bjorkman, A; (2001) Hemoglobin concentration in children in a malaria holoendemic area is determined by cumulated Plasmodium falciparum parasite densities. The American journal of tropical medicine and hygiene, 64 (1-2). pp. 58-66. ISSN 0002-9637

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Abstract

In malaria holoendemic areas children are anemic, but the exact influence of falciparum malaria on hemoglobin (Hb) concentration remains largely unsettled. Prospective data were therefore collected in children < 24 months of age during five months in a Tanzanian village. Children with mean asymptomatic parasitemia > or = 400/microl had lower median Hb levels during the study than those with mean density < 400/microl. The difference was 9.7 g/L (95% confidence interval [CI] 2.8-17). In children with one or more clinical malaria episodes, the median Hb was 8.3 g/L (95% CI 0.9-16) lower than those without episode. If early treatment failure was recorded, the immediate effect on Hb was particularly important with a mean drop of 17 g/L. Interestingly, at study-end the Hb concentration represented a function of the area under the parasitemia curve (AUPC) during the previous five months, adjusting for age. In conclusion, stepwise deterioration in median Hb levels was found by asymptomatic parasitemia, clinical malaria episode, and most significantly, treatment failure.

Item Type: Article
Keywords: Animal, Antimalarials, therapeutic use, Child, Preschool, Chloroquine, therapeutic use, Female, Hemoglobins, metabolism, Human, Infant, Malaria, Falciparum, epidemiology, metabolism, pathology, prevention & control, Male, Parasitemia, metabolism, Plasmodium falciparum, growth & development, Prospective Studies, Randomized Controlled Trials, Recurrence, Support, Non-U.S. Gov't, Tanzania, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 11425164
URI: http://researchonline.lshtm.ac.uk/id/eprint/17853

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