Sumbele Irene Ule Ngole, Kimbi Helen Kuokuo, Ndamukong-Nyanga Judith Lum, Nweboh Malaika, Anchang-Kimbi Judith Kuoh, Lum Emmaculate, Nana Yannick, Ndamukong Kenneth K J, Lehman Leopold G
Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, Buea, Cameroon.
Department of Biological Sciences, Higher Teachers Training College, University of Yaoundé I, Yaoundé, Cameroon.
PLoS One. 2015 Apr 20;10(4):e0123549. doi: 10.1371/journal.pone.0123549. eCollection 2015.
This study examines the relative importance of living in an urban versus rural setting and malaria in contributing to the public health problem of malarial anaemia (MA) and anaemia respectively in apparently healthy primary school children.
A cross-sectional study was conducted among 727 school children aged between four and 15 years living in an urban (302) and rural (425) settings in the Mount Cameroon area. Blood sample collected from each child was used for the preparation of blood films for detection of malaria parasites and assessment of malaria parasite density as well as full blood count determination using an automated haematology analyzer. Based on haemoglobin (Hb) measurements, children with malaria parasitaemia were stratified into MA (Hb<11 g/dL); mild MA (Hb of 8-10.9 g/dL); moderate MA (Hb of 6.1-7.9 g/dL) and severe MA (Hb≤6 g/dL). Evaluation of potential determinants of MA and anaemia was performed by multinomial logistic-regression analysis and odds ratios used to evaluate risk factors.
Out of the 727 children examined, 72 (9.9%) had MA. The prevalence of MA and anaemia were significantly higher (χ2 = 36.5, P <0.001; χ2 = 16.19, P <0.001 respectively) in children in the urban (17.9%; 26.8% respectively) than in the rural area (4.2%; 14.8% respectively). Majority of the MA cases were mild (88.9%), with moderate (5.6%) and severe MA (5.6%) occurring in the urban area only. The age group ≤6 years was significantly (P <0.05) associated with both MA and anaemia. In addition, low parasite density was associated with MA while malaria parasite negative and microcytosis were associated with anaemia.
Malarial anaemia and anaemia display heterogeneity and complexity that differ with the type of settlement. The presence of severe MA and the contributions of the age group ≤6 years, low parasite density and microcytosis to the public health problem of MA and anaemia are noteworthy.
本研究探讨生活在城市与农村环境以及疟疾分别对看似健康的小学生中疟疾性贫血（MA）和贫血这一公共卫生问题的相对重要性。
对喀麦隆山地区727名年龄在4至15岁之间生活在城市（302名）和农村（425名）的学童进行了一项横断面研究。从每个孩子采集的血样用于制备血涂片以检测疟原虫并评估疟原虫密度，以及使用自动血液分析仪进行全血细胞计数测定。根据血红蛋白（Hb）测量结果，患有疟原虫血症的儿童被分层为MA（Hb<11 g/dL）；轻度MA（Hb为8 - 10.9 g/dL）；中度MA（Hb为6.1 - 7.9 g/dL）和重度MA（Hb≤6 g/dL）。通过多项逻辑回归分析对MA和贫血的潜在决定因素进行评估，并使用优势比来评估风险因素。
在727名接受检查的儿童中，72名（9.9%）患有MA。城市儿童中MA和贫血的患病率（分别为χ2 = 36.5，P <0.001；χ2 = 16.19，P <0.001）显著高于农村地区儿童（分别为4.2%；14.8%）。大多数MA病例为轻度（88.9%），中度（5.6%）和重度MA（5.6%）仅发生在城市地区。≤6岁年龄组与MA和贫血均显著相关（P <0.05）。此外，低寄生虫密度与MA相关，而疟原虫阴性和小红细胞症与贫血相关。
疟疾性贫血和贫血表现出与居住类型不同的异质性和复杂性。重度MA的存在以及≤6岁年龄组、低寄生虫密度和小红细胞症对MA和贫血这一公共卫生问题的影响值得关注。
