Hematological Indices in Malian Children Change Significantly during a Malaria Season and with Increasing Age: Implications for Malaria Epidemiological Studies
Hematological Indices in Malian Children Change Significantly during a Malaria Season and with Increasing Age: Implications for Malaria Epidemiological Studies
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DOI：
10.4269/ajtmh.16-0125
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发表时间：
2016-08-01
影响因子：
3.3
通讯作者：
Long, Carole A.
中科院分区：
文献类型：
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作者：
Diakite, Mahamadou;Miura, Kazutoyo;Long, Carole A.
在疟疾流行病学研究中，通常使用标准血液学指数来测量贫血患病率和计算血寄生虫密度。在非洲，很少有研究调查这些指数在疟疾传播季节和年龄增长时如何变化。为了弥补这些知识空白，我们在传播季节之前（2010年5月）和之后（2011年1月）采集了169名3-12岁健康马里儿童的血液。在配对血液样本中测量红细胞（RBC）计数、血红蛋白（Hb）水平、红细胞压积（Ht）、白细胞（WBC）计数和白细胞亚群，并按月份（5月、1月）和年龄组（3-5岁、6-8岁和9-12岁）对数据进行分层。5 - 1月RBC计数(4.53-4.70 × 10(3)/ μ L；P < 0.0001)， Hb水平（11.5 ~ 11.9 g/dL, P < 0.0001）， Ht水平（37.1 ~ 39.2%,P < 0.0001）升高，WBC计数(6.46 ~ 5.96 × 10(3)/L；P = 0.0006)下降。从5月到1月，白细胞亚群的患病率也发生了变化：中性粒细胞占35-43%，单核细胞占6.5-7.6%，淋巴细胞占53-45% （P < 0.001）。这些季节变化与其间经历的疟疾发作次数或RBC多态性的存在无关。5月Hb（11.2、11.4、11.8 g/dL, P = 0.0013）和Ht（36.5%、36.7%、38.1%,P = 0.0154）升高，WBC计数(8.04、6.43、5.76 × 10(3)/ μ L；P < 0.0001)随年龄组降低；1月份也出现了类似的差异。这些数据表明，在疟疾流行病学研究中，需要基于季节和年龄的血液学指标参考值来更好地估计贫血患病率和寄生虫密度。
Standard hematological indices are commonly used in malaria epidemiological studies to measure anemia prevalence and calculate blood parasite densities. In Africa, few studies have investigated how these indices change during a malaria transmission season and with increasing age. To address these knowledge gaps, we collected blood from 169 healthy Malian children aged 3-12 years before (May 2010) and after (January 2011) a transmission season. Red blood cell (RBC) count, hemoglobin (Hb) level, hematocrit (Ht), white blood cell (WBC) count, and WBC subsets were measured in paired blood samples, and the data were stratified by month (May, January) and age group (3-5, 6-8, and 9-12 years). From May to January, RBC count (4.53-4.70 x 10(3)/mu L; P < 0.0001), Hb level (11.5-11.9 g/dL; P < 0.0001), and Ht (37.1-39.2%; P < 0.0001) increased, and WBC count (6.46-5.96 x 10(3)/L; P = 0.0006) decreased. From May to January, the prevalence of WBC subsets also changed: 35-43% neutrophils, 6.5-7.6% monocytes, and 53-45% lymphocytes (P < 0.001). These seasonal changes were not associated with the number of malaria episodes experienced in the interim or the presence of RBC polymorphisms. In May, Hb (11.2, 11.4, and 11.8 g/dL; P = 0.0013) and Ht (36.5%, 36.7%, and 38.1%; P = 0.0154) increased and WBC count (8.04, 6.43, and 5.76 x 10(3)/mu L; P < 0.0001) decreased with age group; similar differences were observed in January. These data suggest that season- and age-based reference values for hematological indices are needed to better estimate anemia prevalence and parasite density in malaria epidemiological studies.