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

Ekvall, Håkan; Premji, Zul; Bennett, Steve; Björkman, Anders

doi:10.4269/ajtmh.2001.64.58

Cited by 26 publications

(20 citation statements)

References 33 publications

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“…However, she recovered completely without clinical symptoms due to anemia. This pattern of marked drop in hemoglobin followed by full recovery is commonly observed also in patients with acute uncomplicated falciparum malaria (Ekvall et al, 2001) and the current study does not show a marked effect of PQ on hemoglobin concentrations post-treatment. It is important to acknowledge that this trial was not designed to look at safety and included only G6PD normal individuals with relatively high hemoglobin concentrations (≥ 8 g/dl).…”

Section: Discussionsupporting

confidence: 80%

The Gametocytocidal Efficacy of Different Single Doses of Primaquine with Dihydroartemisinin-piperaquine in Asymptomatic Parasite Carriers in The Gambia: A Randomized Controlled Trial

et al. 2016

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BackgroundAsymptomatic low-density gametocyte carriers represent the majority of malaria-infected individuals. However, the impact of recommended treatment with single low dose of primaquine and an artemisinin-based combination therapy to reduce transmission in this group is unknown.MethodsThis was a four-arm, open label, randomized controlled trial comparing the effect of dihydroartemisinin-piperaquine (DHAP) alone or combined with single dose of primaquine (PQ) at 0.20 mg/kg, 0.40 mg/kg, or 0.75 mg/kg on Plasmodium falciparum gametocytaemia, infectiousness to mosquitoes and hemoglobin change in asymptomatic, malaria-infected, glucose-6-phosphate dehydrogenase (G6PD) normal individuals. Randomization was done using a computer-generated sequence of uneven block sizes with codes concealed in sequentially numbered opaque envelopes. The primary endpoint was the prevalence of P. falciparum gametocytemia at day 7 of follow-up determined by quantitative nucleic acid sequence based assay and analysis was by intention to treat. The trial has been concluded (registration number: NCT01838902; https://clinicaltrials.gov/ct2/show/NCT01838902).ResultsA total of 694 asymptomatic, malaria-infected individuals were enrolled. Gametocyte prevalence at day 7 was 37.0% (54/146; 95% CI 29.2–45.4), 19.0% (27/142; 95% CI 12.9–26.4), 17.2% (25/145; 95% CI 11.0–23.5) and 10.6% (15/141; 95% CI 6.1–16.9) in the DHAP alone, 0.20 mg/kg, 0.40 mg/kg, and 0.75 mg/kg PQ arms, respectively. The main adverse events reported include headache (130/471, 27.6%), cough (73/471, 15.5%), history of fever (61/471, 13.0%) and abdominal pain (57/471, 12.1%). There were five serious adverse events however, none was related to the interventions.InterpretationA single course of PQ significantly reduces gametocyte carriage in malaria-infected asymptomatic, G6PD-normal individuals without increasing the risk of clinical anemia. The limited number of successful mosquito infections suggests that post-treatment transmission potential in this asymptomatic population is low.

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Section: Discussionsupporting

confidence: 80%

The Gametocytocidal Efficacy of Different Single Doses of Primaquine with Dihydroartemisinin-piperaquine in Asymptomatic Parasite Carriers in The Gambia: A Randomized Controlled Trial

et al. 2016

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“…Sendo assim, necessita de uma atenção especial dos programas de saúde pública 13 . Na África, em regiões holoendêmicas de malária, estudos relatam que a anemia está altamente associada à malária falciparum em crianças, mas que os valores de hemoglobina são influenciados por fatores independentes, como efeito cumulativo por contínuas parasitemias assintomáticas e efeito agudo do episódio clínico, especialmente em falha terapêutica 14 15,16 .…”

Section: Discussão E Consideraçõesunclassified

Malária e aspectos hematológicos em moradores da área de influência dos futuros reservatórios das hidrelétricas de Santo Antônio e Jirau, Rondônia, Brasil

Katsuragawa¹,

Cunha²,

Souza³

et al. 2009

Cad. Saúde Pública

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In Rondônia State, Brazil, two IntroduçãoAs transformações ambientais realizadas pelo homem visando o desenvolvimento e o crescimento da economia são necessárias dentro do contexto social e devem ser realizadas seguindo-se padrões legais, visando causar os menores impactos possíveis. Ambientes aquáticos são amplamente utilizados pelo homem com as mais diferentes finalidades, entre elas o abastecimento de água, geração de energia, irrigação, navegação, piscicultura ou mesmo paisagismo 1 .A construção de barragens para implantação de Usinas Hidrelétricas (UHE) é uma necessidade para o desenvolvimento de uma micro e/ou macro região, pois a oferta de energia elétrica atrai novos investimentos e, com isso, haverá o crescimento da economia local. A Região Norte do Brasil é rica em recursos hídricos. Segundo a Agência Nacional de Energia Elétrica (ANEEL; http://www.aneel.gov.br, acessado em 07/Set/2005), o potencial hidráulico, ou hidroenergético, do país é de 260GW, dos quais apenas 25% estão sendo utilizados para a produção de energia pelas UHE de médio e grande porte e pelas Pequenas Centrais Hidrelétricas (PCH). A Região Norte tem o maior potencial para geração hidráulica com 114GW, ou 44%.Para o Estado de Rondônia, estão planejadas a construção de seis UHE (Jirau, Santo Antônio, Madeira Binacional, Monte Cristo, Ávila e Ji-Paraná) e duas PCH (Cachimbo e Alta Floresta), que

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“…Decrease of haematocrit (or packed cell volume, PCV) and/or haemoglobin concentration also occurs in asymptomatic children both by hemolytic destruction, erythrocyte sequestration and bone marrow suppression [13,16]. Although anaemia (SA, severe anaemia; MA, moderate anaemia) is certainly one of the main consequences of malaria infection and disease, its role as a risk factor for fever incidence has also been suggested, even if this association has yet to be explained [9].…”

Section: Introductionmentioning

confidence: 99%

Patterns of malaria indices across three consecutive seasons in children in a highly endemic area of West Africa: a three times-repeated cross-sectional study

Ardiet¹,

Graz

Szeless

et al. 2014

Malar J

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ObjectivesTo study the manifestations of Plasmodium infection, and its relations with the malaria disease, especially when comparing dry and rainy seasons in a hyperendemic area of West Africa.MethodsThe study was carried out in an area where malaria transmission is high, showing important seasonal variations. One thousand children, representing the total child population (1–12 year old), were observed transversally at the end of three consecutive seasons (dry/rainy/dry). The usual indicators, such as parasite density, splenomegaly, anaemia, or febrile disease were recorded and analysed.ResultsThe prevalence of Plasmodium falciparum was high in all age groups and seasons, constantly around 60%. The high transmission season (rainy) showed higher rates of anaemia and spleen enlargement and, in the youngest children only, higher parasite densities. There were also differences between the two dry seasons: in the first one, there was a higher rate of fever than in the second one (p < 0.001). Low parasite density (<2,000 p/μl) was never associated with fever during any season, raising some concern with regard to the usefulness of parasite detection. The possible origins of fever are discussed, together with the potential usefulness of analyzing these indices on a population sample, at a time when fever incidence rises and malaria is one potential cause among others. The distinction to be made between the Plasmodium infection and the malaria disease is highlighted.ConclusionsThese data confirm previous hypotheses of a strong difference in malaria infection and disease between dry and rainy seasons. The most relevant seasonal indicator was not mainly parasite rate and density but anaemia, spleen enlargement, prevalence and possible origin of fever.RecommendationsIn any situation (i.e. fever or not) and especially during the dry season, one must consider that detection of parasites in the blood is only evidence of a Plasmodium infection and not necessarily of a malaria disease. In such a situation, it seems suitable to obtain, through national malaria teams, a well-defined situation of transmission and prevalence of Plasmodium infection following zones and seasons, in order to adapt control strategies. For researchers, a systematic management of data separately for dry and rainy season appears mandatory.

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

Cited by 26 publications

References 33 publications

The Gametocytocidal Efficacy of Different Single Doses of Primaquine with Dihydroartemisinin-piperaquine in Asymptomatic Parasite Carriers in The Gambia: A Randomized Controlled Trial

The Gametocytocidal Efficacy of Different Single Doses of Primaquine with Dihydroartemisinin-piperaquine in Asymptomatic Parasite Carriers in The Gambia: A Randomized Controlled Trial

Malária e aspectos hematológicos em moradores da área de influência dos futuros reservatórios das hidrelétricas de Santo Antônio e Jirau, Rondônia, Brasil

Patterns of malaria indices across three consecutive seasons in children in a highly endemic area of West Africa: a three times-repeated cross-sectional study

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