Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study.
BACKGROUND: There are few detailed etiologic studies of severe anemia in children from malaria-endemic areas and none in those countries with holoendemic transmission of multiple Plasmodium species. METHODOLOGY/PRINCIPAL FINDINGS: We examined associates of severe anemia in 143 well-characterized Pap...
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ftdoajarticles:oai:doaj.org/article:bc5236a6b5fe4b09bfa85f0a77768a1a 2023-05-15T15:12:24+02:00 Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. Laurens Manning Moses Laman Anna Rosanas-Urgell Pascal Michon Susan Aipit Cathy Bona Peter Siba Ivo Mueller Timothy M E Davis 2012-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001972 https://doaj.org/article/bc5236a6b5fe4b09bfa85f0a77768a1a EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3521670?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 doi:10.1371/journal.pntd.0001972 1935-2727 1935-2735 https://doaj.org/article/bc5236a6b5fe4b09bfa85f0a77768a1a PLoS Neglected Tropical Diseases, Vol 6, Iss 12, p e1972 (2012) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2012 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001972 2022-12-31T13:22:05Z BACKGROUND: There are few detailed etiologic studies of severe anemia in children from malaria-endemic areas and none in those countries with holoendemic transmission of multiple Plasmodium species. METHODOLOGY/PRINCIPAL FINDINGS: We examined associates of severe anemia in 143 well-characterized Papua New Guinean (PNG) children aged 0.5-10 years with hemoglobin concentration <50 g/L (median [inter-quartile range] 39 [33]-[44] g/L) and 120 matched healthy children (113 [107-119] g/L) in a case-control cross-sectional study. A range of socio-demographic, behavioural, anthropometric, clinical and laboratory (including genetic) variables were incorporated in multivariate models with severe anemia as dependent variable. Consistent with a likely trophic effect of chloroquine or amodiaquine on parvovirus B19 (B19V) replication, B19V PCR/IgM positivity had the highest odds ratio (95% confidence interval) of 75.8 (15.4-526), followed by P. falciparum infection (19.4 (6.7-62.6)), vitamin A deficiency (13.5 (5.4-37.7)), body mass index-for-age z-score <2.0 (8.4 (2.7-27.0)) and incomplete vaccination (2.94 (1.3-7.2)). P. vivax infection was inversely associated (0.12 (0.02-0.47), reflecting early acquisition of immunity and/or a lack of reticulocytes for parasite invasion. After imputation of missing data, iron deficiency was a weak positive predictor (6.4% of population attributable risk). CONCLUSIONS/SIGNIFICANCE: These data show that severe anemia is multifactorial in PNG children, strongly associated with under-nutrition and certain common infections, and potentially preventable through vitamin A supplementation and improved nutrition, completion of vaccination schedules, and intermittent preventive antimalarial treatment using non-chloroquine/amodiaquine-based regimens. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 6 12 e1972 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Laurens Manning Moses Laman Anna Rosanas-Urgell Pascal Michon Susan Aipit Cathy Bona Peter Siba Ivo Mueller Timothy M E Davis Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: There are few detailed etiologic studies of severe anemia in children from malaria-endemic areas and none in those countries with holoendemic transmission of multiple Plasmodium species. METHODOLOGY/PRINCIPAL FINDINGS: We examined associates of severe anemia in 143 well-characterized Papua New Guinean (PNG) children aged 0.5-10 years with hemoglobin concentration <50 g/L (median [inter-quartile range] 39 [33]-[44] g/L) and 120 matched healthy children (113 [107-119] g/L) in a case-control cross-sectional study. A range of socio-demographic, behavioural, anthropometric, clinical and laboratory (including genetic) variables were incorporated in multivariate models with severe anemia as dependent variable. Consistent with a likely trophic effect of chloroquine or amodiaquine on parvovirus B19 (B19V) replication, B19V PCR/IgM positivity had the highest odds ratio (95% confidence interval) of 75.8 (15.4-526), followed by P. falciparum infection (19.4 (6.7-62.6)), vitamin A deficiency (13.5 (5.4-37.7)), body mass index-for-age z-score <2.0 (8.4 (2.7-27.0)) and incomplete vaccination (2.94 (1.3-7.2)). P. vivax infection was inversely associated (0.12 (0.02-0.47), reflecting early acquisition of immunity and/or a lack of reticulocytes for parasite invasion. After imputation of missing data, iron deficiency was a weak positive predictor (6.4% of population attributable risk). CONCLUSIONS/SIGNIFICANCE: These data show that severe anemia is multifactorial in PNG children, strongly associated with under-nutrition and certain common infections, and potentially preventable through vitamin A supplementation and improved nutrition, completion of vaccination schedules, and intermittent preventive antimalarial treatment using non-chloroquine/amodiaquine-based regimens. |
format |
Article in Journal/Newspaper |
author |
Laurens Manning Moses Laman Anna Rosanas-Urgell Pascal Michon Susan Aipit Cathy Bona Peter Siba Ivo Mueller Timothy M E Davis |
author_facet |
Laurens Manning Moses Laman Anna Rosanas-Urgell Pascal Michon Susan Aipit Cathy Bona Peter Siba Ivo Mueller Timothy M E Davis |
author_sort |
Laurens Manning |
title |
Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
title_short |
Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
title_full |
Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
title_fullStr |
Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
title_full_unstemmed |
Severe anemia in Papua New Guinean children from a malaria-endemic area: a case-control etiologic study. |
title_sort |
severe anemia in papua new guinean children from a malaria-endemic area: a case-control etiologic study. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2012 |
url |
https://doi.org/10.1371/journal.pntd.0001972 https://doaj.org/article/bc5236a6b5fe4b09bfa85f0a77768a1a |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 6, Iss 12, p e1972 (2012) |
op_relation |
http://europepmc.org/articles/PMC3521670?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 doi:10.1371/journal.pntd.0001972 1935-2727 1935-2735 https://doaj.org/article/bc5236a6b5fe4b09bfa85f0a77768a1a |
op_doi |
https://doi.org/10.1371/journal.pntd.0001972 |
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PLoS Neglected Tropical Diseases |
container_volume |
6 |
container_issue |
12 |
container_start_page |
e1972 |
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1766343084300304384 |