Background: Malaria is a major public health problem in our
countries where its distribution is similar to sickle cell disease. According
to the latest world report on malaria, there are 249 million cases in 2022 with
608,000 deaths.
Children under 5 years old represent approximately 78% of all malaria deaths in
WHO Africa Region where we find 94% of all malaria cases and 95% of deaths
[16=1].
The relationship between sickle cell disease and malaria is the subject of much
controversy. However, there is a lack of data on our services. Our objective
was to study the epidemiological, diagnostic and evolutionary characteristics
of malaria in children with sickle cell disease followed in a specialized
setting.
Patients and Methods: We conducted a retrospective, descriptive, and analytical
study of children with sickle cell disease (SCD) who presented with malaria and
were followed at the Ambulatory Care Unit for Sickle Cell Children and
Adolescents (USAD) at the Albert Royer National Children’s Hospital in Dakar,
Senegal, West Africa from January 1st, 2017, to December 31st, 2019. We included
all the following pediatric patients, less than 16 years, with sickle cell
disease who presented at least one episode of malaria, confirmed by a positive
thick drop, during these 3 years. We did not include patients with incomplete
records or those older than 16 years. The clinical and biological signs, and
the follow-up was collected and analyzed with Excel package 2019.
Results: Of 3773 patients followed for sickle cell disease, 21 had presented
malaria. The frequency was 0.5% or 7 cases/year. However, we exploited the data
of 14 of them. The sex ratio was 6 boys for a girl and the mean age at
admission was 7.3 years. The highest number of malaria cases was observed in
2018 and the peak frequency was observed in November with 8 cases (57.1%). Fever
was the most frequent symptom, observed in 10 patients (71.4%). All patients
were SS homozygous, with a mean baseline hemoglobin level of 7.5g/dl. All
patients had a positive thick blood smear and Plasmodium falciparum was the
only species found in the blood smear, with a mean parasite density of 1693
parasites/ml of blood. All patients had anemia, with a mean hemoglobin level of
7.74 g/dl. Twelve patients (85.7%) were hospitalized and had all received
inject- able artesunate followed by oral Artemisinin Combination Therapy (ACT).
Long-lasting insecticidal nets were used in 9 patients (69.2%). The evolution
was favorable in all patients, and any death was reported.
Conclusion: The patients who presented the association of malaria and sickle
cell disease were all SS homozygotes. However, malaria must be considered as
serious in this chronic anemic setting. That’s why it is important to improve
prophylaxis. Therefore, it is important to make different strategies to reduce
the global burden.
Author(s) Details:
Indou Deme/Ly,
Cheikh Anta Diop University, Dakar, Senegal.
Cheikh
Binetou Fall,
Cheikh
Anta Diop University, Dakar, Senegal.
Awa Kane,
Cheikh Anta Diop University, Dakar, Senegal.
Ibrahima Diop,
Cheikh Anta Diop University, Dakar, Senegal.
Aminata Mbaye,
Cheikh
Anta Diop University, Dakar, Senegal.
Yaaye
Joor Dieng,
Cheikh
Anta Diop University, Dakar, Senegal.
Denika Estelle Liapoui,
Cheikh Anta Diop University, Dakar, Senegal.
Idrissa Demba Ba,
Cheikh Anta Diop University, Dakar, Senegal.
Abou Ba,
Cheikh Anta Diop University, Dakar, Senegal.
Aliou Thiongane,
Cheikh Anta Diop University, Dakar, Senegal.
Papa Moctar Faye,
Cheikh Anta Diop University, Dakar, Senegal.
Amadou Lamine Fall,
Cheikh Anta Diop University, Dakar, Senegal.
Ibrahima Diagne,
Gaston Berger University, Saint-Louis, Senegal.
Ousmane Ndiaye,
Cheikh Anta Diop University, Dakar, Senegal.
Please see the link here: https://stm.bookpi.org/RUDHR-V1/article/view/13215
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