Acheampong Clement O, Barffour Maxwell A, Schulze Kerry J, Chileshe Justin, Kalungwana Ng'andwe, Siamusantu Ward, West Keith P, Palmer Amanda C
College of Health and Human Services, Public Health Program Missouri State University Springfield Missouri USA.
University of Missouri School of Medicine Patient Centered Care Learning Center Columbia Missouri USA.
EJHaem. 2021 Jun 4;2(3):349-356. doi: 10.1002/jha2.243. eCollection 2021 Aug.
Malaria causes anemia by destruction of red blood cells and inhibition of erythropoiesis.
We assessed whether the magnitude of the malaria-specific effect on anemia differs by age, during low and high malaria seasons.
In rural Zambian children participating in a pro-vitamin A efficacy trial, we estimated differences in the prevalence of anemia (defined as hemoglobin < 110 g/L for children < 60 months. and < 115 g/L in older children) by malaria status and assessed malaria-age interactions. Regression models (with anemia as the outcome) were used to model malaria-age interaction in both the low and high malaria seasons, controlling for potential confounders.
Average age was 68 months at baseline ( = 820 children). In the low malaria season, anemia prevalence was 29% in malaria-negative children and 54% in malaria-positive children ( < 0.001), with no malaria-age interactions ( = 0.44). In the high malaria season, anemia prevalence was 41% in malaria-negative children and 54% in malaria-positive children ( < 0.001), with significant malaria-age interactions ( = 0.02 for anemia). Age-stratified prevalence of anemia in malaria positive versus negative children was 67.0% versus 37.1% (in children < 60 months); 57.0% versus 37.2% (in 60-69 months.); 46.8% versus 37.2% (in 70-79 months.); 37.0% versus 37.3% (in 80-89 months) and 28.0% versus 37.4% (in 90+ months).
Malarial anemia is most severe in younger children, especially when transmission is intense. Anemia control programs must prioritize this vulnerable group.
疟疾通过破坏红细胞和抑制红细胞生成导致贫血。
我们评估了在疟疾低发季节和高发季节，疟疾对贫血的特异性影响程度是否因年龄而异。
在参与维生素A原功效试验的赞比亚农村儿童中，我们根据疟疾感染状况估计贫血患病率（定义为60个月以下儿童血红蛋白<110 g/L，60个月及以上儿童血红蛋白<115 g/L）的差异，并评估疟疾与年龄的相互作用。采用回归模型（以贫血为结果变量）对疟疾低发季节和高发季节的疟疾与年龄相互作用进行建模，同时控制潜在的混杂因素。
基线时平均年龄为68个月（n = 820名儿童）。在疟疾低发季节，疟疾阴性儿童的贫血患病率为29%，疟疾阳性儿童为54%（P<0.001），不存在疟疾与年龄的相互作用（P = 0.44）。在疟疾高发季节，疟疾阴性儿童的贫血患病率为41%，疟疾阳性儿童为54%（P<0.001），存在显著的疟疾与年龄的相互作用（贫血的P = 0.02）。疟疾阳性儿童与阴性儿童按年龄分层的贫血患病率分别为67.0%对37.1%（60个月以下儿童）；57.0%对37.2%（60 - 69个月儿童）；46.8%对37.2%（70 - 79个月儿童）；37.0%对37.3%（80 - 89个月儿童）和28.0%对37.4%（90个月及以上儿童）。
疟疾性贫血在幼儿中最为严重，尤其是在传播强烈时。贫血控制项目必须将这一弱势群体作为重点。
