Red cell morphology and malaria anaemia in children with Southeast-Asian ovalocytosis band 3 in Papua New Guinea.
Southeast-Asian ovalocytosis (SAO) was diagnosed in children from Madang, Papua New Guinea, by detection of the SAO band 3 gene variant using the polymerase chain reaction. SAO band 3 was present in 16/241 (6.6%) children living in the community and 32/389 (8.2%) children with acute Plasmodium falciparum malaria (P=0.42). SAO band 3 was detected in 8.2% (23/281) of alpha+-thalassaemia homozygotes, 9.4% (20/214) of heterozygotes and 2.4% (2/85) of children with a normal alpha-globin genotype (P=0.12). The most consistent feature of SAO band 3 on microscopy of thin blood films was red cells with two or more linear or irregularly-shaped pale regions. In children living in the community, these were present in 15 with SAO band 3 (sensitivity 93.8%) and only two normals (specificity 99.1%). The presence of > or = 20% ovalocytosis was a poorer indicator of SAO band 3 (sensitivity 68.8% and specificity 100%). Haematological data were similar in SAO band 3 and normal children. However, in children with acute malaria, haemoglobin levels and red cell counts were significantly lower in SAO band 3 than normal children. The degree of ovalocytosis was lower in children with SAO band 3 during acute malaria, suggesting that a selective loss of ovalocytes may contribute to malaria anaemia in Southeast-Asian ovalocytosis.
O'Donnell
A
A
Institute of Molecular Medicine, University of Oxford, The John Radcliffe Hospital, UK.
Allen
S J
SJ
Mgone
C S
CS
Martinson
J J
JJ
Clegg
J B
JB
Weatherall
D J
DJ
D000740:Anemia / Q000097:blood*; D001457:Anion Exchange Protein 1, Erythrocyte / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004612:Elliptocytosis, Hereditary / Q000097:blood*; D004913:Erythrocytes, Abnormal / Q000378:metabolism*; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood*; D010219:Papua New Guinea; D018512:Parasitemia / Q000378:metabolism; D011446:Prospective Studies; D017085:alpha-Thalassemia / Q000097:blood*
D001457:Anion Exchange Protein 1, Erythrocyte