Influence of plasmodium Falciparum malaria on sickle cell Vaso-occlusive Crisis in Yaoundé, Cameroon

Abstract

Background
Sickle cell disease and malaria infections are common in Cameroon. Malaria infection is thought to influence the occurrence and severity of crisis in sickle cell patients.

Objective
To investigate the relationship between malaria infection and vasoocclusive crisis in sickle cell disease patients.

Methods
In order to investigate the clinical severity of painful vaso-occlusive crisis in sickle cell anaemia patients suffering from malaria infection, 60 SS Homozygous patients aged 2 – 35 years (median = 15 years) with painful crisis and 40 SS Homozygous sickle cell patients in ‘steady state’ aged 1 – 38 years (median = 17 years) were recruited into the study. The clinical severity of the crisis was graded as 0.1 and 2 based on an arbitrary scale for increasing pain. For each participant thin and thick blood films were made from capillary blood, stained according to standard methods and examined for malaria parasites. Chi square and student t tests were used for statistical analysis.

Results
Of the 60 patients in crisis, pain in 46.7% was classified as Grade 1, in 46.7% as Grade 2 and in 6.6% as Grade 0. There were 66.6% of them with positive thick films for malaria parasites compared to 35.0% of the patients in ‘steady state’ (p=0.003). All parasites were shown on thin film to be Plasmodium falciparum. More than 50% of the patients in crisis with positive thick films were in Grade 2 of the clinical grading.

Conclusion
These findings show that falciparum malaria remains a major cause of morbidity and contributes significantly to the occurrence and severity of painful vaso-occlusive crisis in sickle cell disease patients.

Keywords:Plasmodium Falciparum, Malaria, Sickle Cell Disease