Jourdan P M, Laoussou P, Lybie A, Kjetland E F
Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevaal University Hospital, 0407 Oslo, Norway.
West Afr J Med. 2008 Jan;27(1):7-12.
Severe malarial anaemia accounts for nearly one million deaths annually in under-fives in Africa.
To describe the clinical and social indicators of anaemia in under-fives with malaria seeking healthcare at a hospital in northern Cameroon.
This cross-sectional study included 91 consecutive patients below the age of 60 months in whom malaria was diagnosed by symptomatic fever and microscopic examination. Patients were clinically investigated and mothers questioned on related clinical and social aspects.
Anaemia (haemoglobin less than 110 g/L) was detected in 69 (82%), and a high parasite load (more than 100 Plasmodia per 100 high-power fields) in 24 (26%) of the patients. Clinical findings were associated with the levels of haemoglobin, rather than the parasite load in a single blood slide. Anaemia was found significantly more often in children between the ages of 12 and 23 months and in patients born at home (p = 0.035 and p = 0.048 respectively). Severe anaemia (haemoglobin less than 50 g/L) was found significantly more often in patients who had not been vaccinated (p = 0.008).
Anaemia is an important health issue in this population. Clinical signs appear to be associated with the haemoglobin status of the patient rather than the parasite load determined in a single blood slide. Recently weaned children and children of mothers with low socio-economic status and who do not usually use the hospital services, may need particular attention in prevention of anaemia. Further studies are required in order to establish cost-effective interventions against anaemia in under-fives in northern Cameroon.
严重疟疾贫血症每年在非洲五岁以下儿童中导致近100万人死亡。
描述喀麦隆北部一家医院中因疟疾就医的五岁以下儿童贫血的临床和社会指标。
这项横断面研究纳入了91名年龄在60个月以下、通过症状性发热和显微镜检查确诊为疟疾的连续患者。对患者进行临床检查，并询问母亲有关临床和社会方面的问题。
69名（82%）患者检测出贫血（血红蛋白低于110 g/L），24名（26%）患者寄生虫负荷高（每100个高倍视野超过100个疟原虫）。临床发现与血红蛋白水平相关，而非单个血涂片的寄生虫负荷。贫血在12至23个月大的儿童以及在家出生的患者中更为常见（分别为p = 0.035和p = 0.048）。未接种疫苗的患者中严重贫血（血红蛋白低于50 g/L）更为常见（p = 0.008）。
贫血是该人群中的一个重要健康问题。临床体征似乎与患者的血红蛋白状态相关，而非单个血涂片确定的寄生虫负荷。近期断奶的儿童以及社会经济地位低且通常不使用医院服务的母亲所生的儿童，在预防贫血方面可能需要特别关注。需要进一步研究以确定喀麦隆北部五岁以下儿童贫血的经济有效的干预措施。
