Lack of mortality in 22 children with sickle cell anemia and severe malarial anemia

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Robert O Opoka1, Paul Bangirana2, Richard Idro1

  • 1Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.

Pediatric Blood & Cancer
|August 24, 2017
PubMed

Insights

Children with sickle cell anemia (SCA) and severe malaria showed similar mortality rates regardless of sickle cell genotype. Further prospective studies are needed to confirm these findings on malaria mortality in SCA patients.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Genetics

Background:

  • Severe malaria is a significant cause of mortality in children.
  • Sickle cell anemia (SCA) is a common inherited blood disorder.
  • Previous studies suggested higher mortality in children with SCA and severe malaria.

Purpose of the Study:

  • To assess mortality rates in Ugandan children with severe malarial anemia (SMA) and cerebral malaria (CM) based on sickle cell hemoglobin genotype.

Main Methods:

  • Retrospective analysis of mortality data in children with SMA and CM.
  • Comparison of mortality between children with sickle cell hemoglobin genotype HbSS and normal adult hemoglobin.
  • 2-year follow-up mortality assessment.

Main Results:

  • No significant difference in admission or 2-year follow-up mortality was observed between children with SMA and HbSS genotype versus those with normal hemoglobin.
  • The single child with cerebral malaria and HbSS genotype survived.
  • Mortality rates for SMA were 4.5% for HbSS and 3.4% for normal hemoglobin at 2-year follow-up.

Conclusions:

  • Sickle cell hemoglobin genotype (HbSS) did not appear to significantly impact mortality in children with severe malarial anemia or cerebral malaria in this cohort.
  • Findings suggest that the interaction between SCA and severe malaria may not confer the expected increased mortality risk based on genotype alone.
  • Larger prospective studies are recommended to definitively evaluate malaria-related mortality in children with SCA.

Keywords:
mortalitysevere malariasickle cell disease

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