ICMR-National Institute of Malaria Research, New Delhi, India.
Indian Council of Medical Research, New Delhi, India.
Front Public Health. 2022 Jul 28;10:940898. doi: 10.3389/fpubh.2022.940898. eCollection 2022.
Anemia and malaria are the two major public health problems that lead to substantial morbidity and mortality. Malaria infection destroys erythrocytes, resulting in low hemoglobin (Hb) levels known as anemia. Here we report the determinants of anemia in high and low malaria-endemic areas that would help understand which parasite densities, age, and gender-associated low Hb levels. Therefore, a cross-sectional mass survey ( = 8,233) was conducted to screen anemia and malaria in high and low malaria-endemic districts (HMED and LMED) of North-East India. Axillary body temperature was measured using a digital thermometer. The prevalence of anemia was found to be 55.3% (4,547/8,233), of which 45.1% had mild (2,049/4,547), 52.1% moderate (2,367/4,547) and 2.9% had severe anemia (131/4,547). Among anemic, 70.8% (3,219/4,547) resided in LMED and the rest in HMED. The median age of the anemic population was 12 years (IQR: 7-30). Overall, malaria positivity was 8.9% (734/8,233), of which HMED shared 79.6% (584/734) and LMED 20.4% (150/734) malaria burden. The village-wise malaria frequency was concordant to asymptomatic malaria (10-20%), which showed that apparently all of the malaria cases were asymptomatic in HMED. LMED population had significantly lower Hb than HMED [standardized beta (β) = -0.067, < 0.0001] and low-density infections had higher Hb levels than high-density infections (β = 0.113; = 0.031). Women of reproductive age had higher odds for malaria (OR: 1.42; 95% CI: 1.00-2.05; = 0.04). Females (β = -0.193; < 0.0001) and febrile individuals (β = -0.029; = 0.008) have shown lower Hb levels, but malaria positivity did not show any effect on Hb. Young children and women of reproductive age are prone to anemia and malaria. Although there was no relation between malaria with the occurrence of anemia, we found low-density infections, female gender, and LMED were potential determinants of Hb.
贫血和疟疾是导致发病率和死亡率高的两个主要公共卫生问题。疟疾感染会破坏红细胞，导致血红蛋白（Hb）水平降低，即贫血。在这里，我们报告了高、低疟疾流行地区贫血的决定因素，这将有助于了解哪些寄生虫密度、年龄和性别与低 Hb 水平有关。因此，在印度东北部的高、低疟疾流行地区（HMED 和 LMED）进行了横断面大规模调查（n=8233），以筛查贫血和疟疾。使用数字体温计测量腋温。发现贫血的患病率为 55.3%（4547/8233），其中 45.1%为轻度贫血（2049/4547），52.1%为中度贫血（2367/4547），2.9%为重度贫血（131/4547）。在贫血患者中，70.8%（3219/4547）居住在 LMED，其余在 HMED。贫血人群的中位年龄为 12 岁（IQR：7-30）。总体而言，疟疾阳性率为 8.9%（734/8233），其中 HMED 占 79.6%（584/734），LMED 占 20.4%（150/734）。疟疾的村落频率与无症状疟疾（10-20%）一致，这表明 HMED 中所有的疟疾病例显然都是无症状的。LMED 人群的 Hb 明显低于 HMED[标准化β（β）=-0.067，<0.0001]，低密度感染的 Hb 水平高于高密度感染（β=0.113；P=0.031）。育龄妇女患疟疾的可能性更高（OR：1.42；95%CI：1.00-2.05；P=0.04）。女性（β=-0.193；<0.0001）和发热者（β=-0.029；P=0.008）的 Hb 水平较低，但疟疾阳性与 Hb 水平无相关性。幼儿和育龄妇女易患贫血和疟疾。虽然疟疾与贫血的发生之间没有关系，但我们发现低密度感染、女性和 LMED 是 Hb 的潜在决定因素。
