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Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.
Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (c2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters.
Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012].
Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.
Keywords
Sickle cell, genotype, malaria, Plasmodium falciparum, haemoglobin
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View the published article at BMC Infectious Diseases.
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Posted 23 Nov, 2020
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Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 16 Nov, 2020
No comments provided
Reviewer #1 agreed
On 14 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Editor assigned
On 15 Sep, 2020
Reviewers invited
Invitations sent on 15 Sep, 2020
Submission checks complete
On 14 Sep, 2020
Editor invited
On 14 Sep, 2020
No comments provided
Editorial decision: Major revision
On 04 Sep, 2020
Review #1 received
Received 03 Sep, 2020
Reviewer #2 agreed
On 18 Aug, 2020
Review #2 received
Received 18 Aug, 2020
Reviewer #1 agreed
On 12 Aug, 2020
Reviewers invited
Invitations sent on 04 Aug, 2020
Editor assigned
On 28 Jul, 2020
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On 27 Jul, 2020
Editor invited
On 27 Jul, 2020
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Subject Areas
Infectious Diseases
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 3
Posted 23 Nov, 2020
No community comments so far
Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 16 Nov, 2020
No comments provided
Reviewer #1 agreed
On 14 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Editor assigned
On 15 Sep, 2020
Reviewers invited
Invitations sent on 15 Sep, 2020
Submission checks complete
On 14 Sep, 2020
Editor invited
On 14 Sep, 2020
No comments provided
Editorial decision: Major revision
On 04 Sep, 2020
Review #1 received
Received 03 Sep, 2020
Reviewer #2 agreed
On 18 Aug, 2020
Review #2 received
Received 18 Aug, 2020
Reviewer #1 agreed
On 12 Aug, 2020
Reviewers invited
Invitations sent on 04 Aug, 2020
Editor assigned
On 28 Jul, 2020
Submission checks complete
On 27 Jul, 2020
Editor invited
On 27 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background: Sickle cell disease (SCD) is a monogenic disorder due to point mutation in the β-globin gene resulting in substitution of Valine for Glutamic acid. The SCD is prevalent in P. falciparum endemic regions such as western Kenya. Carriage of different sickle cell genotypes may influence haematological parameter during malaria. Children resident in malaria holoendemic regions suffer more from malaria-related complications and this is moderated by the presence of the SCD. In the current study, we determined the association between sickle cell genotypes and haematological parameters in children with P. falciparum malaria resident in Kisumu County in Western Kenya.
Methodology: Children (n=217, aged 1-192 months) with acute febrile condition were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital. Chi-square (c2) analysis was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Multivariate logistic regression analysis controlling for infection status was used to determine the association between sickle cell genotypes and haematological parameters.
Results: Using HbAA as the reference group, multivariate logistic regression analysis revealed that carriage of HbSS was associated with reduced haemoglobin [OR=0.310, 95% CI=0.101-0.956, P=0.041], reduced haematocrit [OR=0.318, 95% CI=0.128-0.793, P=0.014], reduced RBC count [OR=0.124, 95% CI=0.045-0.337, P=0.001], reduced MCHC [OR=0.325, 95% CI=0.118-0.892, P=0.029], increased leucocytosis [OR=9.283, 95% CI=3.167-27.210, P=0.001] and reduced monocytosis [OR=0.319, 95% CI=0.123-0.830, P=0.019]. However, carriage of HbAS was only associated with increased micro-platelets [OR=3.629, 95% CI=1.291-8.276, P=0.012].
Conclusion: Results show that carriage of HbSS in children influence the levels of haemoglobin, haematocrit, RBC, MCHC, WBC and Monocytes. Therefore prior knowledge of HbSS should be considered to improve clinical management of haematological alterations during malaria in children.
This is a list of supplementary files associated with this preprint. Click to download.
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