Effect of Plasmodium falciparum parasitemia density on hemoglobin concentrations among full-term, normal birth weight children in western Kenya, IV.: The Asembo Bay Cohort Project
Effect of Plasmodium falciparum parasitemia density on hemoglobin concentrations among full-term, normal birth weight children in western Kenya, IV.: The Asembo Bay Cohort Project
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DOI：
10.4269/ajtmh.2000.62.504
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发表时间：
2000-04-01
影响因子：
3.3
通讯作者：
Nahlen, BL
中科院分区：
文献类型：
--
作者：
McElroy, PD;ter Kuile, FO;Nahlen, BL
急性高密度恶性疟原虫血症与持续性低密度恶性疟原虫寄生虫血症在导致疟疾性贫血这一公共卫生问题方面的相对重要性仍不清楚。肯尼亚西部的 Asembo 湾队列项目每月收集 1992 年至 1996 年间 942 名单胎活产婴儿的血红蛋白 (Hb) 和寄生虫学测量值，以及每两周一次的抗疟药物使用情况评估。采用适合重复测量数据的混合模型分析来研究随时间变化的寄生虫血症和抗疟药物暴露如何影响平均 Hb 谱。世界卫生组织定义的严重疟疾贫血发病率为每 1000 人年 28.1 例。在 24 个月以下的儿童中，并发寄生虫血症与较低的平均 Hb 显着相关，特别是与没有并发寄生虫血症的儿童相比。 Hb 测量前 90 天寄生虫血症史的密度增加与平均 Hb 水平的相关性比同时发生的寄生虫血症密度的相关性更强。虽然 90 天寄生虫血症史的最高四分位数与最低平均 Hb 水平相关，但与在同一 90 天期间保持无寄生虫血症的儿童相比，处于最低 90 天暴露四分位数的儿童的 Hb 水平仍然显着较低。结果强调了在研究疟疾贫血自然史时收集和分析纵向血红蛋白和寄生虫学数据的重要性。
The relative importance of acute high-density versus persistent low-density Plasmodium falciparum parasitemia in contributing to the public health problem of malarial anemia remains unclear. The Asembo Bay Cohort Project in western Kenya collected monthly hemoglobin (Hb) and parasitologic measurements and biweekly assessments of antimalarial drug use among 942 singleton live births between 1992 and 1996. A mixed-model analysis appropriate for repeated measures data was used to study how time-varying parasitemia and antimalarial drug exposures influenced mean Hb profiles. Incidence of World Health Organization-defined severe malarial anemia was 28.1 per 1,000 person-years. Among children aged less than 24 months, concurrent parasitemia was significantly associated with lower mean Hb, especially when compared to children with no concurrent parasitemia. Increased densities of the 90-day history of parasitemia preceding Hb measurement was more strongly associated with mean Hb levels than concurrent parasitemia density. While the highest quartile of 90-day parasitemia history was associated with lowest mean Hb levels, children in the lowest 90-day exposure quartile still experienced significantly lower Hb levels when compared to children who remained parasitemia-free for the same 90-day period. The results highlight the importance of collecting and analyzing longitudinal Hb and parasitologic data when studying the natural history of malarial anemia.