The Effect Of Alpha-Thalassemia on Malaria Parasitaemia and Microcytic Hypochromic Anaemia in Children Attending the Komfo Anokye Teaching Hospital in the Kumasi Metropolis, Ghana
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Date
2008-08-15
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Abstract
It has been almost entirely established that alpha thalassemia does offer some degree of protection against the deadly consequences of malaria. However, the mechanism of the said protection, and the type of a-thalassemia that offers the said protection have been a point of controversy. In addition to its observed protective influence on malaria, a- thalassemia has also been linked to some other disease conditions. For instance, it is reported to essentially contribute to microcytic hypochromic anemia. This, however, has not yet been fully established, especially in Africa. This study seeks to assess whether a+-thalassemia has a discernible effect on malaria parasitaemia as a mechanism of protection, and also to determine the extent to which it contributes to microcytic hypochromic anemia. Four hundred and fifty-six (456) children presenting with fever were recruited at the Polyclinic out patients department of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. The tests conducted included Malaria Parasite Test, Complete Blood Count (CBC), Serum Ferritin Test, and the Single-tube Multiplex-PCR. Tests were conducted at both KATH and the Kumasi Center for Collaborative Research in Tropical Medicine (KCCR) - a major research facility associated with the Kwame Nkrumah University of Science and Technology (KNUST). Alpha-thalassemic children recorded a significantly lower (28,705.0 pL"1) mean parasite density (MPD) compared to normal/ non-a+-tha!assemic children (35,483.0 pL"') (p<0.0001). Interestingly, the homozygotes recorded a significantly lower (691.3 pL"1) MPD compared to 36,350.0 pL" 1 for the heterozygotes and 35,483.0 pL"1 for the normal/ non-a+-thaiassemic children (p = 0.0001). Out of 120 microcytic hypochromic anemia cases (with iron deficiency excluded), sixty-three (52.50%) had a+-thalassemia, while 38.10% of suspected iron deficiency cases also had a+-thalassemia. Alpha-thalassemia was found to protect against malaria probably via a reduction in the parasite density. The homozygous status was found to be probably responsible for the said protection. Alpha-thalassemia was also found to be a key contributor to microcytic hypochromic anemia. Finally, and quite interestingly, a high prevalence of a+-thalassemia was found amongst cases that were suspected for iron deficiency. This necessitates that suspected iron deficiency cases be screened for a+-thalassemia so as to avoid the unnecessary administration of iron supplement.
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A thesis submitted to the College of Science, Department of Theoretical and Applied Biology, 2008