Haemoglobin dynamics in Papuan and non-Papuan adults in northeast Papua, Indonesia, with acute, uncomplicated vivax or falciparum malaria
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- 作者：Walter RJ Taylor (13) (14)
Hendra Widjaja (13)
Hasan Basri (13)
Emiliana Tjitra (15)
Colin Ohrt (16)
Taufik Taufik (17)
Samuel Baso (18)
Stephen L Hoffman (19)
Thomas L Richie (13) - 关键词：Anaemia ; Malaria ; Papuans ; Indonesia
- 刊名：Malaria Journal
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：12
- 期：1
- 全文大小：383KB
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39. Douglas NM, Anstey NM, Buffet PA, Poespoprodjo JR, Yeo TW, White NJ, Price RN: - 作者单位：Walter RJ Taylor (13) (14)
Hendra Widjaja (13)
Hasan Basri (13)
Emiliana Tjitra (15)
Colin Ohrt (16)
Taufik Taufik (17)
Samuel Baso (18)
Stephen L Hoffman (19)
Thomas L Richie (13)
13. The US Navy Medical Research Unit no. 2 (NAMRU-2), Jakarta, Indonesia
14. Department of Tropical Medicine, Tulane University School of Public Health, New Orleans, USA
15. Centre for Health Research and Development, National Institutes of Health, Jakarta, Indonesia
16. Armed Forces Research Institute of Medical Science, Bangkok, Thailand
17. Indonesian Naval Hospital, Jayapura, Papua, Indonesia
18. Rumah Sakit Umum, Jayapura, Papua, Indonesia
19. Naval Medical Research Center, Bethesda, MD, USA
文摘
Background Haemoglobin (Hb) recovers slowly in malaria and may be influenced by naturally acquired immunity. Hb recovery was compared in malaria immune, indigenous Papuan and non-Papuan adults with limited malaria exposure. Methods Hb concentrations were measured on Days (D) 0, 3, 7, and 28 in 57 Papuans and 105 non-Papuans treated with chloroquine, doxycycline or both drugs for acute, uncomplicated Plasmodium vivax (n = 64) or Plasmodium falciparum (n = 98). Results Mean (SD, range) D0 Hb was 12.7 (2.2, 7-1.3) g/dL and was similar in P. falciparum infected Papuans and non-Papuans: 12.2 vs. 12.8 g/dL (P = 0.15) but significantly lower in: (i) P. vivax-infected Papuans vs. P. vivax-infected non-Papuans: 11.4 vs. 13.47 g/dL [?= ?.07 (95% CI: -.3 --.8), P = 0.0018], (ii) all patients with splenomegaly (vs. those without splenomegaly): 12.16 vs. 13.01 g/dL [?= ?.85 (?.6--.085), P = 0.029], and (iii) all females vs. all males: 10.18 vs. 13.01 g/dL [?= ?.82 (?.97 --.67), P < 0.0001].Multiple regression identified female sex (P = 0.000), longer illness duration (P = 0.015) (P. falciparum patients) and Papuan ethnicity (P = 0.017) (P. vivax patients) as significant factors for a lower D0 Hb. Mean D28 Hb increased to 13.6 g/dL [?= 1.01 (0.5-1.5) vs. D0 Hb, P = 0.0001]. It was: (i) positively correlated with the D0 Hb (adjusted R2 = 0.24, P = 0.000), and was significantly lower in P. vivax infected Papuans vs. non-Papuans: 12.71 vs. 14.46 g/dL [?= ?.7 (?.95--.5, P = 0.006). Conclusions Haemoglobin recovery was related to baseline Hb. Vivax-infected malaria immune Papuans had persistently lower Hb concentrations compared to non-Papuans with limited malaria exposure. This haematological disadvantage remains unexplained.