Malaria as a cause of morbidity and mortality in children with homozygous sickle cell disease on the coast of Kenya.
Malaria as a cause of morbidity and mortality in children with homozygous sickle cell disease on the coast of Kenya.
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DOI：
10.1086/599834
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发表时间：
2009-07-15
期刊：
影响因子：
--
通讯作者：
Williams TN
中科院分区：
文献类型：
--
作者：
Komba AN;Makani J;Sadarangani M;Ajala-Agbo T;Berkley JA;Newton CR;Marsh K;Williams TN
到目前为止，人们普遍认为疟疾是疟疾流行国家中患有镰状细胞病(SCD)儿童发病和死亡的常见原因，因此，通常建议采取疟疾预防措施。然而，几乎没有可用的数据来支持这一做法。我们对1998年7月至2005年6月期间在Kilifi地区医院住院的0-13岁儿童的前瞻性收集的数据进行了回顾分析。我们研究了这些儿童中疟疾感染的患病率、临床特征和结局，按SCD状态分层。虽然我们估计在2006年8月至2008年9月期间，医院周边社区儿童SCD的患病率仅为0.8%(8531名儿童中的71名)，但在研究期间(即1998年7月至2005年6月)入院的34,529名儿童中，有555名(1.6%)为SCD儿童；事实上，共有309名SCD儿童入院555次。患有SCD的儿童恶性寄生虫血症的患病率低于非SCD儿童(551名儿童中86名[15.6%]，33,500名儿童中13,835名[41.3%]；P<；.001)。同样，在感染恶性疟原虫的儿童中，患有SCD的儿童的平均寄生虫密度显著低于非SCD儿童(2205vs.23,878个寄生虫/μL；P<；.001)。86名患有SCD的寄生虫病患者中有14名(16.3%)符合严重疟疾的特征，而13835名未患SCD的寄生虫病患者中有3424名(24.7%)符合严重疟疾的特征(优势比为0.59；P=0.07)。我们没有发现疟疾寄生虫血症和死亡之间的联系。我们发现没有证据支持肯尼亚沿海农村地区患有SCD的儿童患疟疾的风险高于没有SCD的儿童的结论。应开展进一步研究，以帮助政策制定者为疟疾流行地区的SCD患者制定适当的疟疾预防指南。
To date, it has been widely assumed that malaria is a common cause of morbidity and mortality in children with sickle cell disease (SCD) in malaria-endemic countries, and as a result, malarial prophylaxis is commonly recommended. Nevertheless, few data are available that support this practice. We conducted a retrospective analysis of the data collected prospectively from children aged 0-13 years who were admitted to Kilifi District Hospital during the period from July 1998 through June 2005. We studied the prevalence, clinical features, and outcome of malarial infections in these children, stratified by SCD status. Although we estimated the prevalence of SCD in children to be only 0.8% (71 of 8531 children) during the period from August 2006 through September 2008 in the community surrounding the hospital, 555 (1.6%) of 34,529 children admitted to the hospital during the study period (i.e., from July 1998 through June 2005) were children with SCD; in fact, a total of 309 children with SCD were admitted 555 times. The prevalence of Plasmodium falciparum parasitemia was lower among children with SCD than it was among children without SCD (86 [15.6%] of 551 children vs. 13,835 [41.3%] of 33,500 children; P < .001). Similarly, among those infected with P. falciparum parasites, the mean parasite density was significantly lower among children with SCD than it was among children without SCD (2205 vs. 23,878 parasites/μL; P < .001). Fourteen (16.3%) of 86 parasitemic patients with SCD had features consistent with severe malaria, compared with 3424 (24.7%) of 13,835 parasitemic patients without SCD (odds ratio, 0.59; P = .07). We found no association between malarial parasitemia and death. We found no evidence to support the conclusion that the risk of malaria is higher among children with SCD than it is among children without SCD in a rural area on the coast of Kenya. Further studies should be undertaken to help policy makers develop appropriate guidelines regarding malarial prophylaxis for patients with SCD in malaria-endemic regions.
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影响因子：
64.8
作者：
Modiano, D;Luoni, G;Coluzzi, M
通讯作者：
Coluzzi, M
DOI：
10.1080/00034983.1979.11687243
发表时间：
1979-01-01
影响因子：
--
作者：
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通讯作者：
ATTAI, EDE
影响因子：
0.6
作者：
Ambe, JP;Fatunde, JO;Sodeinde, OO
通讯作者：
Sodeinde, OO
影响因子：
6.4
作者：
Williams, TN;Mwangi, TW;Marsh, K
通讯作者：
Marsh, K
影响因子：
64.8
作者：
PASVOL, G;WEATHERALL, DJ;WILSON, RJM
通讯作者：
WILSON, RJM