Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial

Sophie Uyoga; Peter Olupot-Olupot; Roisin Connon; Sarah Kiguli; Robert Opoka; Florence Alaroker; Rita Muhindo; Alexander W. Macharia; Arjen M. Dondorp; Diana M. Gibb

Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial

Sophie Uyoga, Peter Olupot-Olupot, Roisin Connon, Sarah Kiguli, Robert Opoka, Florence Alaroker, Rita Muhindo, Alexander W. Macharia, Arjen M. Dondorp, Diana M. Gibb

Medical College, East Africa

Research output: Contribution to journal › Article

Abstract

Background: Sickle cell anaemia (SCA) has historically been associated with high levels of childhood mortality in Africa. Although malaria has a major contribution to this mortality, to date, the clinical pathology of malaria among children with SCA has been poorly described. We aimed to explore the relationship between SCA and Plasmodium falciparum malaria in further detail by investigating the burden and severity of malaria infections among children recruited with severe anaemia to the TRACT trial of blood transfusion in Africa.

Methods: This study is a post-hoc secondary analysis of the TRACT trial data, conducted after trial completion. TRACT was an open-label, multicentre, factorial, randomised controlled trial enrolling children aged 2 months to 12 years who presented with severe anaemia (haemoglobin

Findings: Between Sept 17, 2014, and May 15, 2017, 3944 children with severe anaemia were enrolled into the TRACT trial. 3483 children from Uganda were considered in this secondary analysis. Overall, 1038 (30%) of 3483 Ugandan children had SCA. 1815 (78%) of 2321 children without SCA (HbAA) tested positive for P falciparum malaria, whereas the prevalence was significantly lower in children with SCA (347 [33%] of 1038; p

Interpretation: The current study suggests that children with SCA are innately protected against classic severe malaria. However, it also shows that even low-level infections can precipitate severe anaemic crises that would likely prove fatal without rapid access to blood transfusion services.

Original language	Undefined/Unknown
Journal	Paediatrics and Child Health, East Africa
Publication status	Published - 1 Sept 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/253

Cite this

Uyoga, S., Olupot-Olupot, P., Connon, R., Kiguli, S., Opoka, R., Alaroker, F., Muhindo, R., Macharia, A. W., Dondorp, A. M., & Gibb, D. M. (2022). Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial. Paediatrics and Child Health, East Africa. http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/253

@article{0990992362124cba97bc864ef1bf29d1,

title = "Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial",

abstract = "Background: Sickle cell anaemia (SCA) has historically been associated with high levels of childhood mortality in Africa. Although malaria has a major contribution to this mortality, to date, the clinical pathology of malaria among children with SCA has been poorly described. We aimed to explore the relationship between SCA and Plasmodium falciparum malaria in further detail by investigating the burden and severity of malaria infections among children recruited with severe anaemia to the TRACT trial of blood transfusion in Africa. Methods: This study is a post-hoc secondary analysis of the TRACT trial data, conducted after trial completion. TRACT was an open-label, multicentre, factorial, randomised controlled trial enrolling children aged 2 months to 12 years who presented with severe anaemia (haemoglobin Findings: Between Sept 17, 2014, and May 15, 2017, 3944 children with severe anaemia were enrolled into the TRACT trial. 3483 children from Uganda were considered in this secondary analysis. Overall, 1038 (30%) of 3483 Ugandan children had SCA. 1815 (78%) of 2321 children without SCA (HbAA) tested positive for P falciparum malaria, whereas the prevalence was significantly lower in children with SCA (347 [33%] of 1038; p Interpretation: The current study suggests that children with SCA are innately protected against classic severe malaria. However, it also shows that even low-level infections can precipitate severe anaemic crises that would likely prove fatal without rapid access to blood transfusion services.",

author = "Sophie Uyoga and Peter Olupot-Olupot and Roisin Connon and Sarah Kiguli and Robert Opoka and Florence Alaroker and Rita Muhindo and Macharia, {Alexander W.} and Dondorp, {Arjen M.} and Gibb, {Diana M.}",

year = "2022",

month = sep,

day = "1",

language = "Undefined/Unknown",

journal = "Paediatrics and Child Health, East Africa",

}

Uyoga, S, Olupot-Olupot, P, Connon, R, Kiguli, S, Opoka, R, Alaroker, F, Muhindo, R, Macharia, AW, Dondorp, AM & Gibb, DM 2022, 'Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial', Paediatrics and Child Health, East Africa. <http://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/253>

TY - JOUR

T1 - Sickle cell anaemia and severe plasmodium falciparum malaria: a secondary analysis of the transfusion and treatment of african children trial

AU - Uyoga, Sophie

AU - Olupot-Olupot, Peter

AU - Connon, Roisin

AU - Kiguli, Sarah

AU - Opoka, Robert

AU - Alaroker, Florence

AU - Muhindo, Rita

AU - Macharia, Alexander W.

AU - Dondorp, Arjen M.

AU - Gibb, Diana M.

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background: Sickle cell anaemia (SCA) has historically been associated with high levels of childhood mortality in Africa. Although malaria has a major contribution to this mortality, to date, the clinical pathology of malaria among children with SCA has been poorly described. We aimed to explore the relationship between SCA and Plasmodium falciparum malaria in further detail by investigating the burden and severity of malaria infections among children recruited with severe anaemia to the TRACT trial of blood transfusion in Africa. Methods: This study is a post-hoc secondary analysis of the TRACT trial data, conducted after trial completion. TRACT was an open-label, multicentre, factorial, randomised controlled trial enrolling children aged 2 months to 12 years who presented with severe anaemia (haemoglobin Findings: Between Sept 17, 2014, and May 15, 2017, 3944 children with severe anaemia were enrolled into the TRACT trial. 3483 children from Uganda were considered in this secondary analysis. Overall, 1038 (30%) of 3483 Ugandan children had SCA. 1815 (78%) of 2321 children without SCA (HbAA) tested positive for P falciparum malaria, whereas the prevalence was significantly lower in children with SCA (347 [33%] of 1038; p Interpretation: The current study suggests that children with SCA are innately protected against classic severe malaria. However, it also shows that even low-level infections can precipitate severe anaemic crises that would likely prove fatal without rapid access to blood transfusion services.

AB - Background: Sickle cell anaemia (SCA) has historically been associated with high levels of childhood mortality in Africa. Although malaria has a major contribution to this mortality, to date, the clinical pathology of malaria among children with SCA has been poorly described. We aimed to explore the relationship between SCA and Plasmodium falciparum malaria in further detail by investigating the burden and severity of malaria infections among children recruited with severe anaemia to the TRACT trial of blood transfusion in Africa. Methods: This study is a post-hoc secondary analysis of the TRACT trial data, conducted after trial completion. TRACT was an open-label, multicentre, factorial, randomised controlled trial enrolling children aged 2 months to 12 years who presented with severe anaemia (haemoglobin Findings: Between Sept 17, 2014, and May 15, 2017, 3944 children with severe anaemia were enrolled into the TRACT trial. 3483 children from Uganda were considered in this secondary analysis. Overall, 1038 (30%) of 3483 Ugandan children had SCA. 1815 (78%) of 2321 children without SCA (HbAA) tested positive for P falciparum malaria, whereas the prevalence was significantly lower in children with SCA (347 [33%] of 1038; p Interpretation: The current study suggests that children with SCA are innately protected against classic severe malaria. However, it also shows that even low-level infections can precipitate severe anaemic crises that would likely prove fatal without rapid access to blood transfusion services.

M3 - Article

JO - Paediatrics and Child Health, East Africa

JF - Paediatrics and Child Health, East Africa

ER -