Short report: Increased susceptibility to Plasmodium malariae in pregnant α+-thalassemic women

Abstract

The influence of α+-thalassemia on malaria in pregnancy was assessed in a cross-sectional study of 530 women in Ghana. Plasmodial infections, α+-thalassemia, serum levels of C-reactive protein, and antimalarial drugs in urine were determined. The α-globin genotypes did not correlate with the prevalence of Plasmodium falciparum-infection and parasite densities. However, Plasmodium malariae tended to be more frequent in α+-thalassemic women (P = 0.05). Excluding women with residual antimalarials, a significant excess of P. malariae was observed in α+-thalassemic individuals. Febrile responses (P = 0.05) and inflammation (CRP > 0.6 mg/dl, P = 0.06) appeared to be less common in infected α+-thalassemic women and were also comparatively rare in parasitemic individuals who harbored double species infections with P. falciparum and P. malariae. Plasmodium malariae may influence the pathogenesis of falciparum malaria leading to a low prevalence of inflammation and febrile responses in α+-thalassemic women.