Michel R, Carnevale P, Bosseno M F, Molez J F, Brandicourt O, Zoulani A, Michel Y
Med Trop (Mars). 1981 Jul-Aug;41(4):403-12.
From 1978 to 1979, 5 surveys, among schoolchildren, were carried out during the rainy season in the neighbourhood of Brazzaville (R.P. Congo): 3 in PK 45 village (northern part of the capital), 2 in Djoumouna village (southern part), and 1 in "Talangai" (a suburb of the capital). 868 exams (plasmodic and splenic index fitted with hemoglobin composition [Hb AA or Hb AS]) were done. It appeared that 19,6% of schoolchildren examined were heterozygous sicklers (AS). This percentage confirmed the previous results from other authors in different countries of Central Africa. On the other hand, in spite of an intense transmission, both plasmodic and splenic index were, on the average, relatively low (24,5 and 24,8% respectively). Plasmodium falciparum was largely predominant (95,3% of infections) but P. ovale and P. malariae were also found (1,9% for each species). From our study no obvious "protecting effect" can be attributed to sickle cell trait because plasmodic index of children AA and AS were similar (23,8 and 27,6% respectively). A slight decrease of splenic index was noticed in AS in regard to AA (19,4 and 26.1% respectively). It is difficult to consider this no significative regression as a definitive proof of a premunition stronger in AS than in AA. Effectively some splenic infarctus are well known to be a regular physiopathological process occurring in homozygous SS but often in heterozygous AS too. In such highly endemic and stable malaria area the problem of a suitable antimalaria strategy remains to be solved.
1978年至1979年雨季期间，在布拉柴维尔（刚果人民共和国）周边地区对学童进行了5次调查：在PK 45村（首都北部）进行了3次，在朱穆纳村（南部）进行了2次，在“塔朗盖”（首都郊区）进行了1次。共进行了868次检查（检测疟原虫和脾脏指数，并分析血红蛋白组成[Hb AA或Hb AS]）。结果显示，接受检查的学童中有19.6%为杂合子镰状细胞贫血患者（AS）。这一百分比证实了中非其他国家其他作者先前的研究结果。另一方面，尽管传播强度很大，但疟原虫指数和脾脏指数平均相对较低（分别为24.5%和24.8%）。恶性疟原虫占主导地位（感染率为95.3%），但也发现了卵形疟原虫和三日疟原虫（每种疟原虫的感染率均为1.9%）。从我们的研究中，无法明确归因于镰状细胞性状的“保护作用”，因为AA和AS儿童的疟原虫指数相似（分别为23.8%和27.6%）。与AA儿童相比，AS儿童的脾脏指数略有下降（分别为19.4%和26.1%）。很难将这种无显著差异的回归视为AS比AA具有更强的先天性免疫力的确凿证据。实际上，一些脾梗死是已知的纯合子SS中经常发生的正常生理病理过程，但杂合子AS中也经常出现。在这种高度流行且稳定的疟疾地区，合适的抗疟疾策略问题仍有待解决。
