Contributions of polyclonal malaria, gametocytemia, and pneumonia to infant severe anemia incidence in malaria hyperendemic Pemba, Tanzania.
The causative factors for severe anemia incidence in sub-Saharan Africa are multifactorial. In an observational, longitudinal study of two cohorts of about 300 infants followed-up for six months in a malaria hyperendemic area, the risk factors for severe anemia incidence were clinical malaria and pneumonia, which outweighed nutritional and sociodemographic factors. Severe anemia incidence was 1-2/year at age 2 months, peaked around 6-7/year at age 7-12 months, and decreased back to 1-2/year at age 16-22 months. The age-dependent increase of severe anemia incidence was shown to be parallel to the age-dependent increase of clinical malaria. Previous clinical malaria episodes increased the severe anemia risk by 80%, and gametocyte carriage and pneumonia at prior visit was associated with a six-fold increase and a > 10-fold increase, respectively. The role of pneumonia and malaria as risk factors, and areas for interventions for severe anemia, should not be underestimated.
Department of International Health, and Department of Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Thomas
T
Jaenisch
Sunil
S
Sazawal
Arup
A
Dutta
Saikat
S
Deb
Mahdi
M
Ramsan
David J
DJ
Sullivan
D000367:Age Factors; D000740:Anemia / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D016778:Malaria, Falciparum / Q000150:complications / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology