Effect of Sickle Cell Allele on Pediatric Malaria and Mortality

Effect of Sickle Cell Allele on Pediatric Malaria and Mortality

Document Type

Abstract

Publication Date

10-2-2019

Abstract

Malaria remains one of the most devastating global health issues the world faces, both in terms of mortality and morbidity. In 2017 there were approximately 219 million new cases of Malaria that resulted in an estimated 435,000 deaths. Plasmodium falciparum makes up about 75% of malaria cases and is typically associated with the most severe symptoms is transmitted by the anopheles mosquito. Plasmodium falciparum completes asexual reproduction inside red blood cells. The presence of the sickle cell allele interferes with this reproduction, meaning that individuals that possess the sickle cell trait tend to have less severe symptoms when infected with malaria. Homozygosity for the sickle cell allele is called sickle cell anemia (SS) and can cause difficulties with circulation as well as pain in the extremities and joints. Heterozygosity for the sickle cell allele is known as sickle cell trait (AS) and does not have deleterious effects and the genotype of normal individuals is denoted as AA. Often malaria presents with flu-like symptoms, such as dizziness or fever, but it can progress to severe malaria (SM). This study divides severe malaria into five categories, listed here from most to least severe: cerebral malaria (CM), Respiratory Distress (RD), malaria with complicated seizures (MS), severe malarial anemia (SMA) and Prostration. Pediatric malaria, cerebral malaria, in particular, can cause difficulties in neurological development. This study follows 720 Ugandan Children from the cities of Kampala and Jinja between the ages of 6 months and four years, grouped by the presentation of their severe malaria, as well as community controls. We found that the prevalence of AS was significantly higher in the control group (10.92%) as compared to those with severe malaria (2.05%, p<.001) than those infected with malaria, indicating that it is protective against malaria infection. The mortality rate of AS individuals (25%) was higher than AA individuals (6.63%) and SS individuals(14.29%), though the difference was not significant (p=.057) this result conflicts with several previous studies that indicate the AS genotype had a protective effect against mortality post-infection.

Department

Wells Center for Pediatric Research Indianapolis, Indiana

Project Mentor

Collaborators and Principal Investigator: Aathira Menon, Katrina Co, John Chandy

Funding and Acknowledgements

Funding: Hubbard Center

Effect of Sickle Cell Allele on Pediatric Malaria and Mortality

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