Publication: An observational study of the effect of hemoglobinopathy, alpha thalassemia and hemoglobin E on P. vivax parasitemia
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Issued Date
2018-01-01
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20353006
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2-s2.0-85045118984
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Mahidol University
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SCOPUS
Bibliographic Citation
Mediterranean Journal of Hematology and Infectious Diseases. Vol.10, No.1 (2018)
Suggested Citation
Suparak Para, Punchalee Mungkalasut, Makamas Chanda, Issarang Nuchprayoon, Srivicha Krudsood, Chalisa Louicharoen Cheepsunthorn An observational study of the effect of hemoglobinopathy, alpha thalassemia and hemoglobin E on P. vivax parasitemia. Mediterranean Journal of Hematology and Infectious Diseases. Vol.10, No.1 (2018). doi:10.4084/mjhid.2018.015 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/47078
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Title
An observational study of the effect of hemoglobinopathy, alpha thalassemia and hemoglobin E on P. vivax parasitemia
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Abstract
© Mediterranean Journal of Hematology and Infectious Diseases 2018. Background: The protective effect of a-thalassemia, a common hematological disorder in Southeast Asia, against Plasmodium falciparum malaria has been well established. However, there is much less understanding of the effect of a-thalassemia against P. vivax. Here, we aimed to investigate the proportion of a-thalassemia including the impact of a-thalassemia and HbE on the parasitemia of P. vivax in Southeast Asian malaria patients in Thailand. Methods: A total of 210 malaria patients, admitted to the Hospital for Tropical Diseases, Thailand during 2011-2012, consisting of 159 Myanmeses, 13 Karens, 26 Thais, 3 Mons, 3 Laotians, and 6 Cambodians were recruited. Plasmodium spp. and parasite densities were determined. Group of deletion mutation (--SEA, -α3.7, -α4.2deletion) and substitution mutation (HbCS and HbE) were genotyped using multiplex gap-PCR and PCR-RFLP, respectively. Results: In our malaria patients, 17/210 homozygous and 74/210 heterozygous -α3.7 deletion were found. Only 3/210 heterozygous -α4.2 and 2/210 heterozygous--SEA deletion were detected. HbE is frequently found with 6/210 homozygotes and 35/210 heterozygotes. The most common thalassemia allele frequencies in Myanmar population were -α3.7 deletion (0.282), followed by HbE (0.101), HbCS (0.013), -α4.2 deletion (0.009), and --SEA deletion (0.003). Only density of P. vivax in a-thalassemia trait patients (-α3.7/-α3.7, --SEA/αα, -α3.7/-α4.2) but not in silent a-thalassemia (-α3.7/αα, -α4.2/αα, ααCS/αα) were significantly higher compared with non-a-thalassemia patients (p=0.027). HbE did not affect P. vivax parasitemia. The density of P. falciparum significantly increased in heterozygous HbE patients (p=0.046). Conclusions: Alpha-thalassemia trait is associated with high levels of P. vivax parasitemia in malaria patients in Southeast Asia.