ABSTRACT
Aims:The aim of this study is to assess the prevalence of hemoglobin abnormalities and G6PD deficiency and their respective influence on anemia occurring in less than five years old children with clinical P. falciparummalaria living in Burkina Faso.Study Design:The study was a cross-sectional survey with descriptive focus conducted from December 2010 to January 2013 in Saponé health district and from May to October 2011 in Banforahealth district. Clinical and laboratory data were collected. Blood smears on slides for malaria diagnosis by microscopy, hemoglobin level and filter paper for the detection of human genetic factors were performed.Methodology:A total of 386 subjects from Saponé (131) and Banfora (255) were enrolled. DNA collected from each sample was extracted using chelex-100 method and the human genetic resistance factors background was assessed by RFLP-PCR. Abnormal hemoglobin patients were classified as NonAA while AA was defined the normal hemoglobin.Results:In this study, 70.98% (274/386) were classified normal hemoglobin (AA) while 29.02% (112/386) of subjects were carrying at least one abnormal (NonAA) allele: 24.35%AC, 3.63% AS, 0.78%CC and 0.26%SC. G6PD deficiency was 9.59% (37/386) among which, 4.92% for male and 4.66% in female. However, this gender difference was not statistically significant (p=1.00). 319/367 (86.92%) of the patients were anemic (59.4% with moderate anemia and 20.98% with mild anemia). Theprevalence of anemia in G6PD deficient subjects was 83.33% (of which 58.33% were moderate anemia and 22.22% mild anemia). The difference between types of hemoglobin (p=0.64) in the occurrence of anemia (AA 87.64% and Non AA 85.18%) was not statistically significant. Conclusion:This study showed that the prevalence of these genetic factors was relatively low among children with clinical falciparummalaria with high parasite density. In addition, these factors appear to have no effect on anemia.
ABSTRACT
Aims:Malariometric indices are essential for the assessment of both new therapies and control strategies. As part of the characterization of a new malaria clinical trial site, this study was carried out to assess malariometric indices during the two seasons ofa Sudanese area of Burkina Faso, in children aged under five years.Study Design:Two community-based cross-sectional surveys were conducted as follow: the first during the rainy season of 2009 and the second during the following dry season. Socio-Original ResearchArticle demographic and clinical data were recorded. A finger prick blood sample was collected to perform malaria blood films and to measure the hemoglobin level.Results:Malaria parasitemia prevalence was 55.2% (N = 677) in the rainy season with a geometric mean of parasite density (GMPD) of 3439 trophozoites/μl against 23.3% (N = 720) in the dry season with a GMPD of 1368 trophozoites/μl. Gametocytemia prevalence was 21.7% and 6.5% respectively in rainy and dry season while splenomegaly prevalence was 11.2% (N = 689) in rainy season against 4.2% (N = 752) in dry season. The prevalence of anemia (hemoglobin < 11.0g/dl) was 90.0% in rainy season and 70.6% in dry season. All indices in rainy season were statistically higher than those in dry season (p-value < 0.0001). The odds of parasite carriage were 3 to 5 times higher in rainy season compared to dry season (95% CI for OR = [3.1, 5.0]).Conclusion:The site is located in a seasonal hyper-endemic malaria area and seems appropriate for the conduct of malaria drugs or vaccines studies. Though the gap between seasons is considerable, the residual level of parasite carriage during low transmission period is not negligible and may command the development of strategies targeting this specific period, to break the chain of transmission of the disease.
ABSTRACT
Aims: The aim of this study was to assess the impact of hemoglobin polymorphisms and G6PD deficiency on the course of uncomplicated malaria infection in children aged from 2 to 10 years in Burkina Faso.Study Design: The study was conducted as a longitudinal study in Banfora health district. A total of 150 children aged from 2 to 10 years was enrolled and followed up between May 2015 and February 2016. Blood samples were collected at four different time points: before infection (Visit 1), during asymptomatic parasitemia (Visit 2), during symptomatic parasitemia (Visit 3) and three weeks after treatment (Visit 4). Clinical examination, hematology parameters and malaria diagnosis using microscopy were performed. Hemoglobin and G6PD typing were done using PCR-RFLP. Hemoglobin AA genotypes were defined as normal hemoglobin while Hemoglobin AC, AS and SS were defined as abnormal hemoglobin (hb non-AA).Results:The prevalence of hemoglobin (hb) genotypes was 81.21% for AA while hb non-AA genotypes were estimated at 18.79% (12.08% for hbAC, 6.04% for hbAS and 0.67% for HbSC). The prevalence of G6PD genotypes was 89.26% and 10.74% for normal G6PDn and G6PD deficiency respectively. The prevalence of asymptomatic carriers of P. falciparumwas not affected neither by the genotypes of Hemoglobin, nor by the G6PD deficiency. Conversely, the risks of developing uncomplicated malaria in G6PD deficiency (G202A) group, was significantly lower (p=0.04).The results showeda significant difference (p˂0.0001) in the means of P. falciparumparasite densities between asymptomatic and symptomatic phase in Hemoglobin AA genotypes carriers while the means of parasite density was comparable in non-Hemoglobin AA carriers. Conclusion:Our study showed that G6PD deficiency protects against clinical malaria while P. falciparumparasite density increasing was correlated with carrying hemoglobin genotypes AA.