Sickle cell disease includes a variety of conditions, including
the homozygous state of the disease, which is commonly known as sickle cell
anaemia. India has a high frequency of the sickle haemoglobin allele, like many
other countries. The common geographical distribution of sickle cell
haemoglobin (HbS) and P. falciparum malaria
in Africa has led to the hypothesis that HbS provides partial protection
against P. falciparum malaria. While
the heterozygous state of the disease (HbAS) is known to provide protection
against P. falciparum malaria, less
is known about the role of the homozygous state (HbSS). P. falciparum infection possibly worsens the clinical condition of
HbSS subjects because of their lower baseline haemoglobin level and with a
hypofunctional spleen. India has the second largest population of sickle cell
disease births after Nigeria. The disease is found predominantly in the
malaria-endemic areas of central India. However, the clinical presentation of
HbSS subjects seems far more benign in India than in Africa, with fewer
complications in childhood and a higher longevity. The clinical consequence of P. falciparum infection in Indian HbSS
subjects is not clearly known. It is also not known whether the homozygous
(HbSS) state in India provides similar protection as that of the heterozygous
(HbAS) state against P. falciparum malaria,
considering their benign clinical presentation, particularly in childhood. A
cohort study recruiting HbS infants from P.
falciparum malaria endemic areas in India will help in understanding the
interaction of disease-modifying factors as well as the impact of P. falciparum infection on the severity
of the disease, and whether antimalarial prophylaxis is indicated.
Author(s) Details
Padmalaya
Das
Amity Institute of Biotechnology, Amity University, Raipur,
Chhattisgarh, India.
Please
see the book here:- https://doi.org/10.9734/bpi/aodhr/v3/5699
