Anemia, Iron Supplementation and Susceptibility to Plasmodium falciparum Malaria

Adam, Ishag

doi:10.1016/j.ebiom.2016.11.036

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…However, lead no longer seemed to have a significant protective impact on malaria incidence after 12 months of age in children. Numerous studies within malaria-endemic regions of the world have exhibited identified iron deficiency as a protective factor against malaria [24–26]. However, we found no significant associations between iron deficiency status in children and malaria outcomes in univariate analyses to support these previous findings.…”

Section: Discussioncontrasting

confidence: 55%

Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa

et al. 2019

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Lead and malaria both present significant health risks to children in Sub-Saharan Africa. Previous studies have shown that high blood lead levels in children act as a protective factor against subsequent malaria incidence. The main objective of this study was to investigate associations between blood lead level and malaria outcomes prospectively in Beninese children from 12 to 24 months of age. Two-hundred and four children were assessed for lead at 12 months and closely followed until 24 months for malaria; when symptoms and parasite density were also recorded. Univariate and multivariate negative binomial and linear regression models tested associations between blood lead level quartile and total episodes of malaria (total symptomatic and asymptomatic episodes) and parasite density, respectively. Median blood lead level among children measured at 12 months was 56.50 (4.81–578) μg/L. During the 12-month follow-up, 172 (84.31%) children had at least one malaria episode. Univariate and multivariate negative binomial and linear regressions did not reveal significant associations between blood lead level quartile and malaria outcomes. Iron deficiency was not found to be an effect modifier. Results from this prospective child-cohort study investigating associations between blood lead level and malaria did not confirm results from previous cross-sectional studies. Further research is needed to further explore this relationship and other co-morbidities due to malaria and lead.

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Section: Discussioncontrasting

confidence: 55%

Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa

et al. 2019

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“…Some authors have suggested that anemia could be an adaptation to living in malaria-endemic regions. [8] In contrast, Brisbe et al found a prevalence of 10.5% in their series. [9] However, unlike ours, only patients billed for orthopedic surgery were recruited in their study and, additionally, their geographical location is in the Western world where malaria is not endemic.…”

Section: Discussionmentioning

confidence: 74%

Prevalence of pre-operative anemia and its implication for patient blood management in a Nigerian Hospital

Kalu

Usoro

Etta

et al. 2022

CJHS

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Objectives: Pre-operative anemia is common in Sub-Saharan Africa including Nigeria. Anemia is a known risk factor for blood transfusion. In our hospital, like many others, patients are usually admitted a day before elective surgeries and the default treatment for anemia by most surgeons and anesthetists is allogenic blood transfusion. Anemia and blood transfusion are independently and synergistically associated with complications and undesirable outcomes. Patient blood management (PBM) is gaining popularity and has been advocated by the World Health Organization (WHO) for member countries to adopt as a means of improving patient outcomes. There is currently no research from the University of Calabar Teaching Hospital highlighting the prevalence of pre-operative anemia. This research was aimed at filling this gap and also presenting a baseline for comparison as the hospital strives to implement the three pillars of PBM strategies: Manage anemia, minimize blood loss and harness tolerance to anemia to improve patient outcomes. Material and Methods: All surgical patients who consented to the study were recruited prospectively. Patients who had no pre-operative hemoglobin (Hgb) or packed cell volume (PCV) recorded were excluded from the study. Demographic data, type of surgery, and pre-operative PCV levels were documented. Anemia was defined using the WHO standard as PCV <39% (Hgb 13.0 g/dL) in men and <36% (Hgb 12.0 g/dL) in women. Data were obtained about transfusion at the end of surgery. Surgeries were categorized into general, orthopedic, obstetric, gynecological, urologic, pediatric, ear, nose, throat/maxillofacial, burns and plastic unit (BPU), neurological, and thoracic. The information was entered into SPSS version 20. Data were cleaned and analyzed. The statistical significance was placed at P < 0.05. Results are presented as tables, chats, and histograms. Results: A total of 237 patients were recruited with a mean age of 37.30 ± 19.05. More of them were females (54.0%) and a higher proportion of them (64.6%) had elective surgery. The categories of surgeries were predominantly general surgical (24.9%) and gynecological (21.9%) followed by orthopedic (17.7%), ENT/maxillofacial (9.3%), urologic (8.0%), and obstetric (7.2%) cases. The rest were neurosurgical (3.4%) and pediatric surgical (2.1%) cases. The overall prevalence of anemia was found to be 54.9%. The mean pre-operative PCV was 34.90 ± 7.37%. The highest proportion of pre-operative anemia was found among the pediatric surgical cases (80.0%) followed by the urologic (68.4%) and neurosurgical cases (62.5%). The prevalence of pre-operative anemia among the different surgical patients was gynecological (46.2%), general surgical (45.8%), obstetric (41.2%), ENT/maxillofacial (40.9%), and orthopedic (38.1%) cases. The lowest proportion of pre-operative anemic patients was found among the thoracic (25.0%) and Burns and Plastics (11.1%) cases. Most of the patients (86.5%) were not transfused intraoperatively. Whereas 20% of the anemic patients were transfused; only 5.6% of the non-anemic ones needed a blood transfusion. Conclusion: Pre-operative anemia remains prevalent in our environment and anemia is a risk factor for a blood transfusion which carries both risk and cost implications. PBM has as its first pillar the management of anemia. This pre-emptive approach to allogeneic blood transfusion avoidance is aimed at improving patient outcomes. Prevention and treatment of pre-operative anemia will be beneficial not just to the patients but to all healthcare stakeholders.

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“…However, anemia as low as 4% and as high as 25% have been reported. 12 Haroon et al, also reported contrasting results with anemia more prevalent in the plasmodium falciparum group. 13 One of the commonly occurring clinical entity in the patients having malaria, for which the causative agent is plasmodium falciparum is thromobocytopenia.…”

Section: Discussionmentioning

confidence: 96%

Alteration of Coagulation Profile in Malaria Patients and its Correlation with The Degree of Parasitemia

Jabeen

Naeem

Uddin

et al. 2022

PAFMJ

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Objective: To determine the alteration of coagulation profile (PT, APTT, D-dimers) in malaria patients and its correlation with the degree of Parasitemia.Study Design: Cross-sectional study. Place and Duration of Study: Pathology department of Combined Military Hospital Lahore, from Jan to July 2018. Methodology: A total of 92 patients were included in the study. The malarial parasite was identified using thick and thin smears. Hemoglobin, Red blood cell, White blood Count, Prothrombin Time, Activated Partial Thromboplastin Time, and Ddimer levels were measured using automated analyzers Sysmex KX-21 and CA-600. Results: The mean age of the patients was 23.35 ± 14.4 years with 53 (57.6%) males and 39 (42.4%) females. Plasmodium falciparum was identified as the causative species in 33 (35.9%) of the cases, 59 (64.1%) cases were caused by Plasmodium vivax. Based on parasitic load, 50 (54.3%) patients were found to have a mild degree of parasitemia whereas 26 (28.3%) had moderate and 16 (17.4%) had severe parasitemia. A significant association was found between the degree of parasitemia and coagulation parameters. Conclusion: Partial thromboplastin time, activated partial thromboplastin time and D-dimer levels were positively correlated with the degree of parasitemia specifically in plasmodium falciparum as compared to the other species. Therefore, special care should be exercised in patients having an underlying inherited bleeding disorder and a strict prevention protocol should be made.

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Anemia, Iron Supplementation and Susceptibility to Plasmodium falciparum Malaria

Cited by 10 publications

References 9 publications

Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa

Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa

Prevalence of pre-operative anemia and its implication for patient blood management in a Nigerian Hospital

Alteration of Coagulation Profile in Malaria Patients and its Correlation with The Degree of Parasitemia

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