无症状亚显微和显微疟疾感染与贫血之间的关联：在贝宁南部的一项研究。

Association between asymptomatic submicroscopic and microscopic malaria infections and anemia: A study in southern Benin.

作者信息

Chaves Alejandro Rojas, Dossou Yannelle, Djènontin Armel, Adimi Elisée, Akoho Romuald, Bailly Justine, Bouraïma Aziz, Matondo Déborah, Sissinto Yolande, Houinato Dismand, Massougbodji Achille, Dechavanne Célia, Cottrell Gilles

机构信息

Université Paris Cité, IRD, MERIT, F-75006, Paris, France.

Institut de Recherche Clinique du Bénin/IRCB, Abomey-calavi, Bénin.

出版信息

PLoS One. 2025 Jan 24;20(1):e0317345. doi: 10.1371/journal.pone.0317345. eCollection 2025.

DOI:10.1371/journal.pone.0317345

PMID:39854542

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11759402/

Abstract

INTRODUCTION

Recently, efforts to eliminate malaria have shifted focus from symptomatic cases alone to include asymptomatic carriers, who are now recognized as significant contributors to the disease's transmission and control. This study examines the relationship between asymptomatic malaria infection and hemoglobin levels in Benin.

METHODS

A cohort in Benin was enrolled and categorized into three age groups (under 5 years, 5-15 years, and over 15 years) for follow-up from August to November 2021. Participants were monitored over two months and assessed for malaria infection through microscopy and polymerase chain reaction (PCR) during their three visits. A questionnaire was employed to gather general and clinical characteristics. Multivariate models were utilized to analyze the associations between asymptomatic infection, anemia, and hemoglobin levels.

RESULTS

Among 393 participants, 58.2% were diagnosed at enrolment with malaria via PCR, and 30.5% through microscopy. Anemia, defined as hemoglobin levels < 11 g/dL, was observed in 40.5% of the cohort. The risk of anemia declined with increasing age (OR for ages 5-15: 0.64, 95% CI [0.37; 1.09]; OR for over 15 years: 0.34, 95% CI [0.20; 0.59]) compared to children under 5. Individuals with both microscopic and submicroscopic infections exhibited higher odds of anemia (respectively OR = 4.15, 95% CI [2.41; 7.13] and OR = 2.09 [1.22; 3.57]) relative to those uninfected. Hemoglobin levels were consistently lower in participants with microscopic malaria across all age groups (β = -2.73, 95% CI [-3.41; -2.05] for those under 5, β = -1.35, 95% CI [-1.89; -0.82] for ages 5-15, and β = -0.72, 95% CI [-1.34; -0.07]) compared to non-infected individuals.

DISCUSSION

Our findings suggest that asymptomatic malaria infections, including submicroscopic cases, are associated with anemia and decreased hemoglobin levels. This underscores the importance of employing ultrasensitive diagnostic methods for such infections and acknowledging their potential health implications.

摘要

引言

最近，消除疟疾的努力已将重点从仅关注有症状病例转向包括无症状携带者，现在人们认识到无症状携带者是疾病传播和控制的重要因素。本研究考察了贝宁无症状疟疾感染与血红蛋白水平之间的关系。

方法

在贝宁招募了一个队列，并将其分为三个年龄组（5岁以下、5至15岁和15岁以上），于2021年8月至11月进行随访。对参与者进行了两个月的监测，并在他们三次就诊期间通过显微镜检查和聚合酶链反应（PCR）评估疟疾感染情况。采用问卷调查收集一般和临床特征。利用多变量模型分析无症状感染、贫血和血红蛋白水平之间的关联。

结果

在393名参与者中，58.2%在入组时通过PCR被诊断为疟疾，30.5%通过显微镜检查被诊断为疟疾。队列中40.5%的人被诊断为贫血，定义为血红蛋白水平<11 g/dL。与5岁以下儿童相比，贫血风险随着年龄增长而降低（5至15岁的OR为0.64，95%CI[0.37；1.09]；15岁以上的OR为0.34，95%CI[0.20；0.59]）。与未感染个体相比，显微镜检查和亚显微镜感染的个体贫血几率更高（分别为OR = 4.15，95%CI[2.41；7.13]和OR = 2.09[1.22；3.57]）。在所有年龄组中，显微镜下检测到疟疾的参与者的血红蛋白水平始终较低（5岁以下的β = -2.73，95%CI[-3.41；-2.05]；5至15岁的β = -1.35，95%CI[-1.89；-0.82]；15岁以上的β = -0.72，95%CI[-1.34；-0.07]），与未感染个体相比。