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Relationship between blood Lead status and anemia in Ugandan children with malaria infection
Ambrose Mukisa1, Denis Kasozi1, Claire Aguttu1
1Department of Biochemistry and Sports Science, College of Natural Sciences, Makerere University, Kampala, Uganda.
Insights
Environmental lead exposure significantly worsens anemia in Ugandan children, particularly when combined with malaria infection. This study highlights lead toxicity as a key factor in anemia pathogenesis, exacerbating the condition in co-infected children.
Area of Science:
- Environmental Health
- Pediatric Anemia
- Toxicology
Background:
- Childhood anemia is a significant health issue in Uganda, linked to malaria and iron deficiency.
- Iron deficiency is influenced by nutrition, age, helminths, and lead toxicity.
- Environmental lead exposure increases blood lead (BL) levels, competitively inhibiting iron absorption and hemoglobin synthesis.
Purpose of the Study:
- To investigate the contribution of lead toxicity to anemia pathogenesis in Ugandan children under five.
- To assess the combined impact of malaria infection and environmental lead pollution on anemia status.
Main Methods:
- Analyzed blood samples from 198 children for malaria parasite density (PD) and hemoglobin (Hb) concentrations.
- Measured blood lead (BL) and free erythrocyte protoporphyrin (FEP) levels using standard spectrophotometric and fluorometric methods.
- Employed regression analysis to determine correlations between PD, Hb, BL, and FEP.
Main Results:
- Over 76% of children had moderate anemia (Hb <10 g/dL), with a mean blood lead level of 8.6 µg/dL.
- A significant negative correlation was found between FEP/Hb and Hb (r = -0.6, P=0.001), indicating lead's impact.
- Malaria parasite density showed a weaker negative correlation with Hb (r = -0.231, P<0.001).
Conclusions:
- Blood lead levels significantly contribute to the development of anemia in children.
- Co-exposure to malaria infection and lead pollution exacerbates anemia severity.
- Lead toxicity is a critical factor in understanding and managing childhood anemia in affected regions.
Background:
In Uganda, childhood anemia remains a health challenge and is associated with malaria infection as well as iron deficiency. Iron deficiency is intertwined with nutritional status, age and other comorbidities including helminths and Lead toxicity. Environmental Lead levels accounts for one's blood Lead (BL) levels. Blood Lead competitively blocks iron absorption, inhibits hemoglobin (Hb) biosynthesis and elevates free erythrocyte protoporphyrin (FEP) levels. Lead toxicity's contribution towards anemia pathogenesis, especially during malaria infection has not been studied. Concomitant exposure to both malaria infection and Lead pollution, exacerbates the anemia status. This study therefore aimed at expounding the anemia status of these Ugandan children aged under 5years who are exposed to both malaria infection and environmental Lead pollution.
Methods:
Briefly, venous blood samples from 198 children were microscopically assayed for malaria parasite density (PD), and hemoglobin (Hb) concentrations using the cyanmethemoglobin method, while BL and FEP levels were determined by the standard atomic absorption spectrophotometric and fluorometric methods respectively.
Results:
One hundred and fifty-one (76.3%) of the children analyzed had moderate anemia (Hb <10>5 g/dL) with Means of BLL=8.6 µg/dL, Hb =7.5 g/dL, FEP/Hb =8.3 µg/g and PD =3.21×103 parasites / µL, while eight (4%) were severely anemic (<5 g/dL). Regression analysis and statistical correlation between PD and Hb (r = -0.231, R2= 0.15 P-value < 0.001) was negative and weak as compared to that between FEP/Hb and Hb (r = -0.6, R2=0.572 P-value=0.001).
Conclusion:
Based on the study's findings, we conclude that BL significantly contributes to the pathogenesis of anemia and therefore its co-existence with malaria infection in the host exacerbates the anemia status.
