Abstract
Purpose. There is widespread subclinical (asymptomatic) malaria in our locality. The effects exerted by malaria on the body iron status remain incompletely understood. The aim of this study was to investigate the prevalence of malarial iron‐deficiency anaemia and the effect of asymptomatic malaria on iron status indicators.
Design. A cross‐sectional prospective study.
Methods. Seven parameters, haemoglobin concentration, white blood cell (WBC) count, malaria parasite, serum iron, total iron binding capacity (TIBC), serum ferritin, and percentage transferrin saturation, were evaluated among 240 children of both genders, aged 1–8 years. Estimation of the variables was carried out using standard haematological, colorimetric and enzyme‐linked immunosorbent assay procedures.
Results. Of the 240 children surveyed, 66 (27.5%) were parasitized with Plasmodium falciparum. The overall prevalence of iron‐deficiency anaemia (defined as haemoglobin <11 g dl−1, serum ferritin <12 ng ml−1 and transferrin saturation <16%) in this study population was 9/240 (3.75%). The prevalence of iron‐deficiency anaemia among the parasitized children was 9/66 (13.6%). Their mean parasite density (3.35×103 parasites µl−1) was higher than the mean parasite density of the entire study population (1.16×103 parasites µl−1). No significant change in the haemoglobin concentration, WBC and serum ferritin values was observed between the parasitized and non‐parasitized children (p>0.05), whereas a marked decrease in the serum iron, TIBC and percentage transferrin saturation values in the parasitized children was observed when compared with the non‐parasitized group (p<0.02, 0.02 and 0.01). The percentage transferrin saturation correlated directly and significantly with haemoglobin, serum iron and TIBC values (r = 0.317, 0.617, 0.236; p<0.01, p<0.01 and p<0.05). The reduction in the haemoglobin concentration, serum ferritin and percentage transferrin saturation values became evident when age was introduced into the analysis, with the children below 5 years of age more affected.
Conclusions. We conclude that: (1) asymptomatic malaria infection exerts significant effects on iron indicators; (2) an increase in transferrin saturation may be an indication of iron availability and vice versa; (3) children younger than 5 years of age constitute a high‐risk group in malaria‐endemic regions of developing countries; (4) there was a high prevalence of asymptomatic malaria and a low prevalence of iron‐deficiency anaemia.