Relationship between blood Lead status and anemia in Ugandan children with malaria infection

Mukisa, Ambrose; Kasozi, Denis M; Aguttu, Claire; Vuzi, Peter C.; Kyambadde, Joseph

doi:10.1186/s12887-020-02412-2

Cited by 8 publications

(22 citation statements)

References 37 publications

(43 reference statements)

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“…The remaining 13 studies were assessed for full texts; then, seven studies were excluded with reasons: three reviews, one systematic review, one study without data on malaria and lead, one comment, and one case report. Finally, six eligible studies [11,[18][19][20][21]24] were included in the qualitative and quantitative syntheses (Figure 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…The included studies were published between 2011 and 2020 and conducted between 2005 and 2013. Three studies were conducted in Nigeria (3/6, 50%) [11,19,20], two studies were conducted in Benin (2/6, 33.3%) [18,24], and one study was conducted in Uganda [21]. Three studies had cross-sectional design [18,19,21], while two studies were prospective observational design [11,20], and one study had a cohort design [24].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Three studies were conducted in Nigeria (3/6, 50%) [11,19,20], two studies were conducted in Benin (2/6, 33.3%) [18,24], and one study was conducted in Uganda [21]. Three studies had cross-sectional design [18,19,21], while two studies were prospective observational design [11,20], and one study had a cohort design [24]. Five studies enrolled children age between 1 and 9 years [18][19][20][21]24], while only one study enrolled pregnant women [11].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Three studies had cross-sectional design [18,19,21], while two studies were prospective observational design [11,20], and one study had a cohort design [24]. Five studies enrolled children age between 1 and 9 years [18][19][20][21]24], while only one study enrolled pregnant women [11]. Among studies that enrolled children, one study enrolled children with venous blood lead level (VBLL) >45 mg/dL before chelation [20], and one study enrolled children with malaria [21].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Previous epidemiological studies showed that blood lead level (BLL) was associated with malaria infection [11,18,19]. Moreover, some studies reported that BLL increased the risk of severe malaria, including that of neurological disorder [20] and severe anemia [21]. However, limited data were available to verify the evidence.…”

Section: Introductionmentioning

confidence: 99%

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Blood Lead Levels and Subsequence Risk of Malaria in the African Population: A Systematic Review and Meta-Analysis

Kuraeiad

Kotepui

2021

TropicalMed

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Previous epidemiological studies showed that blood lead level (BLL) was associated with malaria infection and severity. Therefore, the present study aimed to qualitatively and quantitatively synthesize the evidence on the association between BLL and risk of malaria infection and severity using the systematic review and meta-analysis approach. Potentially relevant studies were identified from three databases using a combination of search terms. The quality of the included studies was assessed using the checklist for the cross-sectional studies developed by the Joanna Briggs Institute. The qualitative synthesis of the risk or odds of malaria infection in patients with BLL was performed as the outcome of each included study could not be pooled. The pooled mean BLL and prevalence of malaria infection of the included studies was estimated using a random-effect model. The heterogeneity of the outcomes among the included studies was assessed using the Cochran Q test and I2 statistics. The subgroup analysis of the study sites and participants was performed to explore the source(s) of heterogeneity of the outcomes. Publication bias was assessed in the case of more than 10 studies used for pooling of the same outcome. Among 114 potentially relevant studies identified from the databases, 6 eligible studies were included for qualitative and quantitative syntheses. The results showed that the pooled mean BLLs were 7.33 μg/dL in children (95% confidence interval (95%CI), 4.08–10.58; I2, 98.2%), 7.94 μg/dL in children with BLL > 45 mg/dL before chelation (95%CI, 7.87–8.01), 7.41 μg/dL in infants (95%CI, 7.34–7.48 μg/dL), 9.20 μg/dL in children with malaria (95%CI, 9.16–9.24 μg/ dL), and 36.37 μg/dL in pregnant women (95%CI, 34.43–38.31 μg/dL). The prevalence rates of malaria among participants (2381 participants, 803 malaria-positive patients) were 53% in children (95%CI, 50–57%; I2, 99.8%), 24% in children with BLL > 45 mg/dL before chelation (95%CI, 21–27%), 12% in infants (95%CI, 8–18%), and 21% in pregnant women (95%CI, 18–26%). The subgroup analysis of countries demonstrated that the prevalence rates of malaria among participants was 17% in Benin (95%CI, 13–21%; I2, 98.8%) and 36% in Nigeria (95%CI, 10–63%; I2, 99.4%). BLL associated with decreased risk of malaria was demonstrated by two studies conducted in Benin and Nigeria, while BLL associated with increased risk of malaria was demonstrated by a study conducted in Nigeria. BLL was associated with the risk of severe malaria, involving severe neurological features and severe anemia. In conclusion, the present systematic review and meta-analysis determined the current status of the studies on BLL and risk of malaria in African countries. Further studies are needed to investigate the impact of BLL on patients with malaria to help the clinician determine the risk of severity, such as the development of neurological features or severe anemia, among patients exposed to lead.

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