The Influence of Hemoglobin Variants on Plasmodium falciparum Parasite Density

Malaria and sickle cell disease are public health problem in sub-Saharan Africa. We study the influence of hemoglobin type on parasite density in suspected sickle cell malaria patients in Maradi (Niger). This was a descriptive study with retrospective data collection between 2012 and 2023. Electrophoresis methods were used to determine the hemoglobin type and thick smear for the parasite density. This study included 875 participants with a sex ratio of 1.06 and a mean age of 14.25 years (range: 2 months to 80 years). Thick smear analysis of all participants revealed 52.91% positive, and the arithmetic mean of 242 p/uL (40 p/uL - 2600 p/uL). The most prevalent hemoglobin types were hemoglobin A (66.17%), following with hemoglobin S (29.14%) and hemoglobin C (3.66%). The geometric mean of the parasite density applied to the hemoglobin type shows that hemoglobin C (289.65 p/uL) and hemoglobin S (291.39 p/uL) stand out as being the highest. These results show that the differences in parasite density between hemoglobin A, hemoglobin S and hemoglobin C are statistically significant (p= 2.28x10-59). Regression analysis showed that hemoglobin C had a significant positive influence (p=0.029) on parasite density. The hemoglobin A2, hemoglobin F and hemoglobin S, did not have a statistically significant impact on parasite density. According to this study, person with predominant hemoglobin S and hemoglobin C have highest parasitemia than patients with predominant hemoglobin A type. It’s necessary to conduct others studies to determine the mechanism by how hemoglobin type affects parasite density in malaria.