Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum
Abstract Background Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of ana...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03212-w |
| _version_ | 1819057559502323712 |
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| author | Richard O. Mwaiswelo William Mawala Per O. Iversen Mariane de Montalembert Lucio Luzzatto Julie Makani |
| author_facet | Richard O. Mwaiswelo William Mawala Per O. Iversen Mariane de Montalembert Lucio Luzzatto Julie Makani |
| author_sort | Richard O. Mwaiswelo |
| collection | DOAJ |
| description | Abstract Background Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, and contribute to early childhood mortality. Case presentation A 17 year-old Tanzanian male with known SCD was admitted to Muhimbili National Hospital, a tertiary referral centre in Dar-es-Salaam, following an attack of malaria. From 2004 to 2007 the patient had lived in USA, and from 2010 to 2016 in France where, on account of hypersplenism and episodes of splenic sequestrations, in 2014 the spleen was removed. After appropriate clinical and laboratory assessment the patient was re-started on hydroxyurea; and anti-malarial-prophylaxis with proguanil was instituted. The patient has remained well and malaria-free for the following 15 months. Conclusion SCD patients are highly vulnerable to malaria infection, and impaired splenic function is a feature of SCD patients, even in those who still anatomically have a spleen. This patient had a surgical splenectomy and, in addition, had probably lost some of the acquired malaria-immunity by having lived for several years in malaria-free areas. This patient is a compelling reminder that long-term anti-malarial prophylaxis should be offered to all patients with SCD who live in malaria-endemic areas. |
| first_indexed | 2024-12-21T13:41:14Z |
| format | Article |
| id | doaj.art-55d9bb9b30b645a0812fdbeed8075512 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-21T13:41:14Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-55d9bb9b30b645a0812fdbeed80755122022-12-21T19:02:01ZengBMCMalaria Journal1475-28752020-04-011911510.1186/s12936-020-03212-wSickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparumRichard O. Mwaiswelo0William Mawala1Per O. Iversen2Mariane de Montalembert3Lucio Luzzatto4Julie Makani5Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial UniversityDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied SciencesDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied SciencesDepartment of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de ParisDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied SciencesDepartment of Hematology and Blood Transfusion, Muhimbili University of Health and Allied SciencesAbstract Background Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, and contribute to early childhood mortality. Case presentation A 17 year-old Tanzanian male with known SCD was admitted to Muhimbili National Hospital, a tertiary referral centre in Dar-es-Salaam, following an attack of malaria. From 2004 to 2007 the patient had lived in USA, and from 2010 to 2016 in France where, on account of hypersplenism and episodes of splenic sequestrations, in 2014 the spleen was removed. After appropriate clinical and laboratory assessment the patient was re-started on hydroxyurea; and anti-malarial-prophylaxis with proguanil was instituted. The patient has remained well and malaria-free for the following 15 months. Conclusion SCD patients are highly vulnerable to malaria infection, and impaired splenic function is a feature of SCD patients, even in those who still anatomically have a spleen. This patient had a surgical splenectomy and, in addition, had probably lost some of the acquired malaria-immunity by having lived for several years in malaria-free areas. This patient is a compelling reminder that long-term anti-malarial prophylaxis should be offered to all patients with SCD who live in malaria-endemic areas.http://link.springer.com/article/10.1186/s12936-020-03212-wChemoprophylaxisMalariaSickle cell diseaseSplenic dysfunctionSplenectomy |
| spellingShingle | Richard O. Mwaiswelo William Mawala Per O. Iversen Mariane de Montalembert Lucio Luzzatto Julie Makani Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum Malaria Journal Chemoprophylaxis Malaria Sickle cell disease Splenic dysfunction Splenectomy |
| title | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
| title_full | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
| title_fullStr | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
| title_full_unstemmed | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
| title_short | Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum |
| title_sort | sickle cell disease and malaria decreased exposure and asplenia can modulate the risk from plasmodium falciparum |
| topic | Chemoprophylaxis Malaria Sickle cell disease Splenic dysfunction Splenectomy |
| url | http://link.springer.com/article/10.1186/s12936-020-03212-w |
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