Sickle Cell Disease and Severity of Malaria
Maman Daou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger and Hôpital National de Niamey, Niger.
Ibrahim Alkasoume
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Mahamadou Doutchi
Faculté de Médecine de l’université de Zinder, Niger.
Samaila Boubacar
Hôpital National de Niamey, Niger.
Mansour Maman Anou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Mahamane Moustapha lamine
Centre de Recherche Médicale et Sanitaire de Niamey, Niger and Université Cheikh Anta Diop de Dakar, Sénégal.
Ramatoulaye Hamidou Lazoumar
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.
Kamayé Moumouni
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger and Hôpital National de Niamey, Niger.
Djibo Yacouba Hamadou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Ibrahim Maman Laminou *
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.
*Author to whom correspondence should be addressed.
Abstract
Background: The relationship between sickle cell disease and malaria remains controversial and the hypothesis that sickle cell disease protects against malaria is widespread.
Methodology: A descriptive and retrospective study over a two-year period (2014-2016) was conducted in pediatric departments of the National Hospital of Niamey (NHN). The objective is to assess the relative risk between sickle cell disease and the severity of malaria.
Results: Nine hundred and seventy four (974) patients infected with Plasmodium falciparum were included in this study. Thirteen point twenty four percent (129/974) of patients had sickle cell disease, of which 93.8% (121/129) had SS form and 6.2% (8/129) SC form. Seventy-nine point eight percent (103/129) of sickle cell patients had severe malaria (RR = 0.9, p = 0.17). Ninety six point one percent (99/103) of patients with severe malaria were homozygous SS versus 3.8% (4/103) who were heterozygous SC (RR = 0.6, p = 0.05). Eleven point forty three percent (4/35) of sickle cell patients died of malaria (RR = 0.1, p = 0.4). Seventy-five percent (3/4) of the deceased sickle cell were homozygous SS versus 25% (1/4) who were heterozygous SC (RR = 5, p = 0.2).
Conclusion: Heterozygous sickle cell patients have less severe malaria than homozygotes. Malaria is more severe and more lethal in homozygous sickle cell patients. A strategy for the prevention of sickle cell malaria should be developed during periods of high transmission.
Keywords: Relationship, sickle cell disease, malaria, Severe and Niger.