Haemoglobin genotype of children with severe malaria seen at the University of Benin Teaching Hospital, Benin city, Nigeria

Abstract

Abstract: Introduction: Types of haemoglobin (Hb) genotype have been found to be crucial to the rate of red blood cell parasite invasion, multiplication, and destruction as well as outcome of malaria disease. In a bid to provide more information on the relationship between Hb genotype and level of protection conferred by genotype against severe forms of malaria, this study was undertaken. This is done through evaluation of forms of Hb genotype in children with severe malaria seen in University of Benin Teaching Hospital (UBTH), Benin City. Patients and methods: This crosssectional study was carried out on children (6 - 60 months old) admitted for severe malaria using standard World Health Organization (WHO) guidelines. Diagnosis of malaria was by microscopic demonstration of parasitaemia or serology (in those with negative parasitaemia). Hb genotype was done using the Hb electrophoresis. Results: Ninety-six well nourished children; (56(58.3%) males and 40 (41.7%) females) mean age (± SD) 29.22 ± 16.02 months were recruited for the study. Sixty-eight (73.4%) of the 92 subjects had Hb genotype AA while 24(26.1%) Had abnormal Hb genotype. Prevalence of severe malaria in children with abnormal Hb was 20/24 (83.3%) as against 58/68(85.3%) observed in those with HbAA. Significantly fewer incidence of heavy malaria parasitaemia (3+ and 4+) was observed in children with abnormal Hb genotype. Heavy parasite density was the most important features of severe malaria in children with HbAA (p= 0.013) as against altered sensorium, prostration, and haemoglobinuria in children with abnormal Hb genotype (p = 0.003, 0.041, and 0.023 respectively). Children with HbAA were also about 3 times more likely to die from severe malaria (p = 0.567, O.R = 2.96) when compared with their counterparts with abnormal Hb. Conclusion: Study supports a higher prevalence of severe malaria in children with HbAA when compared with those with abnormal Hb genotype. Altered sensorium, prostration and haemoglobinuria were the significant presenting features of severe malaria in children with abnormal Hb genotype in this study.

Key words: children, genotype, haemoglobin, mortality, severe malaria