The US Navy Medical Research Unit no. 2-NAMRU-2, Jakarta, Indonesia.
Malar J. 2013 Jun 19;12:209. doi: 10.1186/1475-2875-12-209.
Haemoglobin (Hb) recovers slowly in malaria and may be influenced by naturally acquired immunity. Hb recovery was compared in malaria immune, indigenous Papuan and non-Papuan adults with limited malaria exposure.
Hb concentrations were measured on Days (D) 0, 3, 7, and 28 in 57 Papuans and 105 non-Papuans treated with chloroquine, doxycycline or both drugs for acute, uncomplicated Plasmodium vivax (n = 64) or Plasmodium falciparum (n = 98).
Mean (SD, range) D0 Hb was 12.7 (2.2, 7–21.3) g/dL and was similar in P. falciparum infected Papuans and non-Papuans: 12.2 vs. 12.8 g/dL (P = 0.15) but significantly lower in: (i) P. vivax-infected Papuans vs. P. vivax-infected non-Papuans: 11.4 vs. 13.47 g/dL [Δ = −2.07 (95% CI: –3.3 – –0.8), P = 0.0018], (ii) all patients with splenomegaly (vs. those without splenomegaly): 12.16 vs. 13.01 g/dL [Δ = −0.85 (−1.6– –0.085), P = 0.029], and (iii) all females vs. all males: 10.18 vs. 13.01 g/dL [Δ = −2.82 (−3.97 – –1.67), P < 0.0001].Multiple regression identified female sex (P = 0.000), longer illness duration (P = 0.015) (P. falciparum patients) and Papuan ethnicity (P = 0.017) (P. vivax patients) as significant factors for a lower D0 Hb. Mean D28 Hb increased to 13.6 g/dL [Δ = 1.01 (0.5-1.5) vs. D0 Hb, P = 0.0001]. It was: (i) positively correlated with the D0 Hb (adjusted R2 = 0.24, P = 0.000), and was significantly lower in P. vivax infected Papuans vs. non-Papuans: 12.71 vs. 14.46 g/dL [Δ = −1.7 (−2.95– –0.5, P = 0.006).
Haemoglobin recovery was related to baseline Hb. Vivax-infected malaria immune Papuans had persistently lower Hb concentrations compared to non-Papuans with limited malaria exposure. This haematological disadvantage remains unexplained.
在疟疾中，血红蛋白（Hb）的恢复速度较慢，可能受到自然获得性免疫的影响。本研究比较了疟疾免疫的巴布亚人和非巴布亚土著成年人以及疟疾暴露有限的非巴布亚成年人的 Hb 恢复情况。
57 名巴布亚人和 105 名非巴布亚人因急性、无并发症的间日疟原虫（n=64）或恶性疟原虫（n=98）感染而接受氯喹、多西环素或两种药物治疗，在第 0、3、7 和 28 天测量 Hb 浓度。
平均（SD，范围）D0 Hb 为 12.7（2.2，7-21.3）g/dL，且恶性疟原虫感染的巴布亚人和非巴布亚人之间无显著差异：12.2 与 12.8 g/dL（P=0.15）；但在以下人群中显著更低：（i）间日疟原虫感染的巴布亚人与间日疟原虫感染的非巴布亚人相比：11.4 与 13.47 g/dL[Δ=-2.07（95%CI：-3.3--0.8），P=0.0018]；（ii）所有脾肿大患者（与无脾肿大患者相比）：12.16 与 13.01 g/dL[Δ=-0.85（-1.6--0.085），P=0.029]；（iii）所有女性与所有男性相比：10.18 与 13.01 g/dL[Δ=-2.82（-3.97--1.67），P<0.0001]。多元回归分析确定了女性（P=0.000）、更长的疾病持续时间（P=0.015）（恶性疟原虫患者）和巴布亚种族（P=0.017）（间日疟原虫患者）是 D0 Hb 较低的显著因素。平均 D28 Hb 增加至 13.6 g/dL[Δ=1.01（0.5-1.5）与 D0 Hb，P=0.0001]。它与 D0 Hb 呈正相关（调整后的 R2=0.24，P=0.000），且间日疟原虫感染的疟疾免疫巴布亚人与非巴布亚人相比显著更低：12.71 与 14.46 g/dL[Δ=-1.7（-2.95--0.5，P=0.006）]。
Hb 恢复与基线 Hb 相关。与疟疾暴露有限的非巴布亚人相比，感染间日疟原虫的疟疾免疫的巴布亚人 Hb 浓度持续较低。这种血液学劣势仍未得到解释。
