Sickle cell hemoglobinopathies and malaria infection: an experience in tertiary care level referral hospital, ahmedabad, gujarat, india

Introduction: Malaria is major public health threat in India. . Hb S carriers are protected from malaria infection. Despite this advantage, individuals with sickle cell disease exhibit significant morbidity and mortality due to malaria.(1)
Aims and Objective: This study aims to highlight malarial infection in sickle cell hemoglopathies and to emphasis upon the need for detailed research to find out association between sickle cell hemoglobinopathies and severity of malaria. In this study our aim was to study the occurance of malaria and its incidence, severity, clinical features,complications and role of spleen in sickle cell hemoglobinopathies.To know the effect of malaria infection on the maternal and child health.
Material and Method: This was a retrospective analysis of the data collected from children age 1 to 18 years and adults admitted to civil Hospital during July 2011 to july 2018. A total of 10 samples received in hematology, department of pathology ,B.J.Medical College,Ahmedabad were studied, relevant information regarding age,sex,accompanying clinical symptoms, complications has been documented radiological and other biochemical test parameters were also recorded. Various parameters were recorded from automated cell counter machine. Peripheral smear was prepared.Rapid Diagnostic Test test,Sickling test and High Performance Liquid Chromatography test was done.
Result: Out of 10(100%) cases,7(70%) males including pediatric males(3) and 3(30%) female patient including (1) pediatric female patient with sickle cell hemognopathies were positive for malarial infection. Amongst 3 females 1 patient was presented with 8 months of pregnancy with sickle cell disease and p.vivax infection. All the patients had sickle cell hemognopathies and had positive sickling test. Ratio of male:female was 2.3:1. Affected patients showed anemia with complications like high grade fever, sickle painful crisis, jaundice followed by acute respiratory distress.
Conclusion: Malaria and sickle cell anemia are still major public health problems. The need for detailed research to find out association between sickle cell hemoglobinopathies and severity of malaria. Males are more commonly affected than females. Poor outcome of malaria in pregnant woman and children with sickle cell disease. In malaria endemic countries patient with SCA and particularly children, be protected from malaria by appropriate prophylaxis like vaccine. Systematic screening for malaria and sickle cell anemia should be integrated into maternal and child health services for conflict affected populations in highly endemic tribal areas especially during rainy season to reduce maternal and fetal complications.