The etiology of severe anemia in a village and a periurban area in Mali

Dicko, Alassane; Klion, Amy D.; Théra, Mahamadou A.; Sagara, Issaka; Yalcouye, Daniel; Niambele, Mohamed B.; Sogoba, Moussa; Dolo, Guimogo; Dao, Adama; Diallo, Dapa A.; Doumbo, Ogobara K.; Miller, Louis H.

doi:10.1182/blood-2003-11-3884

Cited by 31 publications

(41 citation statements)

References 12 publications

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“…Mortality is greatest when anaemia is severe (Hb < 50 g/l), and complicated by other signs of severity [ 40]. Two factors correlate best with the development of severe anaemia: haemoglobin concentration preceding the malaria transmission season, and the parasite density achieved during incident infections [ 41]. We found no evidence for an effect of α + -thalassaemia on either of these parameters.…”

Section: Discussionmentioning

confidence: 78%

The Effect of α +-Thalassaemia on the Incidence of Malaria and Other Diseases in Children Living on the Coast of Kenya

et al. 2006

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BackgroundThe α-thalassaemias are the commonest genetic disorders of humans. It is generally believed that this high frequency reflects selection through a survival advantage against death from malaria; nevertheless, the epidemiological description of the relationships between α-thalassaemia, malaria, and other common causes of child mortality remains incomplete.Methods and FindingsWe studied the α +-thalassaemia-specific incidence of malaria and other common childhood diseases in two cohorts of children living on the coast of Kenya. We found no associations between α +-thalassaemia and the prevalence of symptomless Plasmodium falciparum parasitaemia, the incidence of uncomplicated P. falciparum disease, or parasite densities during mild or severe malaria episodes. However, we found significant negative associations between α +-thalassaemia and the incidence rates of severe malaria and severe anaemia (haemoglobin concentration < 50 g/l). The strongest associations were for severe malaria anaemia (> 10,000 P. falciparum parasites/μl) and severe nonmalaria anaemia; the incidence rate ratios and 95% confidence intervals (CIs) for α +-thalassaemia heterozygotes and homozygotes combined compared to normal children were, for severe malaria anaemia, 0.33 (95% CI, 0.15,0.73; p = 0.006), and for severe nonmalaria anaemia, 0.26 (95% CI, 0.09,0.77; p = 0.015). ConclusionsOur observations suggest, first that selection for α +-thalassaemia might be mediated by a specific effect against severe anaemia, an observation that may lead to fresh insights into the aetiology of this important condition. Second, although α +-thalassaemia is strongly protective against severe and fatal malaria, its effects are not detectable at the level of any other malaria outcome; this result provides a cautionary example for studies aimed at testing malaria interventions or identifying new malaria-protective genes.

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Section: Discussionmentioning

confidence: 78%

The Effect of α +-Thalassaemia on the Incidence of Malaria and Other Diseases in Children Living on the Coast of Kenya

et al. 2006

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“…We found that Ab levels to Pf proteins rose dramatically in children during the 6-month malaria season; however, most of this response appeared to be short-lived based on cross-sectional analysis at the end of the 6-month dry season, which revealed only modest incremental increases in Ab levels with age. Because there is little to no Pf transmission at the study site during the 6-month dry season (12,13) and IgG has a half-life of ∼21 days (48), we infer that Pf-specific Abs in circulation at the end of the dry season are generated by long-lived plasma cells (LLPCs), whereas the increase in Ab levels observed after the malaria season likely reflects the differentiation of naive and/or memory B cells (MBCs) into short-lived plasma cells (SLPCs) that disappear by the end of the next dry season. Thus, it appears that the Pf-specific LLPC compartment gradually "fills" with repeated Pf exposure.…”

Section: Discussionmentioning

confidence: 99%

A prospective analysis of the Ab response to Plasmodium falciparum before and after a malaria season by protein microarray

Crompton

Kayala²,

Traoré³

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

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Abs are central to malaria immunity, which is only acquired after years of exposure to Plasmodium falciparum (Pf). Despite the enormous worldwide burden of malaria, the targets of protective Abs and the basis of their inefficient acquisition are unknown. Addressing these knowledge gaps could accelerate malaria vaccine development. To this end, we developed a protein microarray containing ∼23% of the Pf 5,400-protein proteome and used this array to probe plasma from 220 individuals between the ages of 2-10 years and 18-25 years in Mali before and after the 6-month malaria season. Episodes of malaria were detected by passive surveillance over the 8-month study period. Ab reactivity to Pf proteins rose dramatically in children during the malaria season; however, most of this response appeared to be short-lived based on cross-sectional analysis before the malaria season, which revealed only modest incremental increases in Ab reactivity with age. Ab reactivities to 49 Pf proteins measured before the malaria season were significantly higher in 8-10-year-old children who were infected with Pf during the malaria season but did not experience malaria (n = 12) vs. those who experienced malaria (n = 29). This analysis also provided insight into patterns of Ab reactivity against Pf proteins based on the life cycle stage at which proteins are expressed, subcellular location, and other proteomic features. This approach, if validated in larger studies and in other epidemiological settings, could prove to be a useful strategy for better understanding fundamental properties of the human immune response to Pf and for identifying previously undescribed vaccine targets.antigen discovery | naturally acquired immunity | Plasmodium falciparum malaria | prospective cohort study | Mali

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“…It may be due to a single causative agent or factor or an interaction among several causative agents or factors. In most cases, it is due to two or more causative agents rather than a single one [1][2][3] . Malaria, bacteraemia, helminthiasis, human parvovirus B19 (B19V) infection and other infections such as tuberculosis and HIV/AIDS have been widely reported as important factors contributing to the high prevalence of anaemia in many populations [3][4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

Duedu

Sagoe

Ayeh‐Kumi

et al. 2013

Asian Pacific Journal of Tropical Biomedicine

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The etiology of severe anemia in a village and a periurban area in Mali

Cited by 31 publications

References 12 publications

The Effect of α +-Thalassaemia on the Incidence of Malaria and Other Diseases in Children Living on the Coast of Kenya

The Effect of α +-Thalassaemia on the Incidence of Malaria and Other Diseases in Children Living on the Coast of Kenya

A prospective analysis of the Ab response to Plasmodium falciparum before and after a malaria season by protein microarray

The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

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