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The role of red blood cell polymorphisms in resistance and susceptibility to malaria

B Lell1, J May, R J Schmidt-Ott

  • 1Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Germany.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 29, 2000
PubMed

Insights

Red cell polymorphisms like sickle cell trait and blood group A influence malaria severity in children. Sickle cell trait is linked to milder malaria, while blood group A is associated with severe cases.

Area of Science:

  • Malariology
  • Human Genetics
  • Epidemiology

Background:

  • Regions endemic for Plasmodium falciparum malaria exhibit widespread red cell polymorphisms conferring resistance to severe disease.
  • Understanding these genetic factors is crucial for managing malaria's public health impact.

Purpose of the Study:

  • To investigate the association between specific red cell polymorphisms and the severity of Plasmodium falciparum malaria in Gabonese children.
  • To evaluate the impact of these polymorphisms on reinfection rates and disease presentation.

Main Methods:

  • Determined sickle cell trait, alpha-thalassemia, glucose-6-phosphate dehydrogenase deficiency, and blood groups in 100 children with severe malaria and 100 with mild malaria.
  • Matched cases and controls, followed up for reinfections, parasitemia, and hematocrit levels.

Main Results:

  • Sickle cell trait was significantly associated with mild malaria; blood group A was linked to severe malaria.
  • Children with severe malaria experienced higher reinfection rates, higher parasitemia, and lower hematocrit levels upon follow-up.
  • Sickle cell trait correlated with lower parasitemia levels, irrespective of reinfection incidence.

Conclusions:

  • Malaria severity is partly determined by the presence of blood group A and sickle cell trait.
  • Differential reinfection patterns suggest varying host susceptibility to malaria based on prior disease severity and red cell polymorphisms.

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