Sickle Cell Disease and Severity of Malaria
Background: The relationship between sickle cell disease and malaria remains controversial and the hypothesis that sickle cell disease protects against malaria is widespread.
Methodology: A descriptive and retrospective study over a two-year period (2014-2016) was conducted in pediatric departments A and B of the National Hospital of Niamey (HNN). The objective is to assess the relative risk between sickle cell disease and the severity of malaria.
Results: Nine hundred and seventy four (974) patients infected with Plasmodium falciparum were included in this study. Thirteen point twenty four percent (129/974) of patients had sickle cell disease, of which 93.8% (121/129) had SS form and 6.2% (8/129) SC form. Seventy-nine point eight percent (103/129) of sickle cell patients had severe malaria (RR = 0.9, p = 0.17). Ninety six point one percent (99/103) of patients with severe malaria have SS hemoglobin versus 3.8% (4/103) who have SC hemoglobin (RR = 0.6, p = 0.05). Eleven point forty three percent (4/35) of sickle cell patients died of malaria (RR = 0.1, p = 0.4). Seventy-five percent (3/4) of the deceased sickle cell have SS hemoglobin versus 25% (1/4) who have SC hemoglobin (RR = 5, p = 0.2).
Conclusion: Heterozygous sickle cell patients have less severe malaria than homozygotes. Malaria is more severe and more lethal in homozygous sickle cell patients. A strategy for the prevention of sickle cell malaria should be developed during periods of high transmission.
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Ibrahim Maman Laminou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Hôpital National de Niamey, Niger.
Faculté de Médecine de l’université de Zinder, Niger.
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.
Université Cheikh Anta Diop de Dakar, Sénégal.
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