Defectos eritrocíticos y densidad de la parasitemia en pacientes con malaria por Plasmodium falciparum en Buenaventura, Colombia

Abstract

To determine the prevalence of some erythrocyte defects and to evaluate the relation that that has with parasitemia density in individuals diagnosed with Plasmodium falciparum malaria in a population in the Pacific coastal region of Colombia. This prevalence study was carried out with 242 persons with P. falciparum malaria who had gone for consultation at the Program of Tropical Diseases diagnostic center in the city of Buenaventura, Colombia. The parasitemia levels were measured, and also determined was the presence of congenital erythrocyte defects (glucose-6-phosphate dehydrogenase (G6PD) deficiency, abnormal hemoglobins, and thalassemias) and of other factors possibly related to parasitemia levels. The prevalence of erythrocyte defects was 26.4% (95% confidence interval, 21.0%-32.5%), which was similar to what had been found in previous studies in the same area of Colombia. In the multiple regression models, individuals with sickle cell anemia or a complete deficiency of G6PD had a lower density of parasitemia than did persons without any erythrocyte defect. After adjusting for other variables of interest, the risk of high parasitemias was lower in persons with sickle cell anemia (odds ratio = 0.30) and individuals with a complete deficiency of G6PD (odds ratio = 0.72). Our results confirm the high prevalence of erythrocyte defects in Colombia's Pacific coastal region, in a population with ethnic characteristics that are similar to those of some populations in West Africa. Our results also lend support for the existence of innate resistance to malaria among carriers of hemoglobin AS and in persons with G6PD deficiency.