Association between sickle cell trait and Plasmodium falciparum infection: evidence for age-specific protection in a cross-sectional study in Guinea-Bissau
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Sickle cell trait (SCT) remains poorly documented in Guinea-Bissau. We aimed to investigate SCT frequency, its geographic-ethnic distribution, and association with Plasmodium falciparum infection. METHODS: DNA from 601 dried whole blood samples collected in the 2017 national malaria prevalence survey underwent β-globin genotyping. SCT (HbAS) and HbAA distributions were examined across health regions and ethnic groups. Associations with P. falciparum, parasitemia, anemia, and fever were evaluated using chi-square and Mann-Whitney U tests and logistic regression models (IBM SPSS Statistics, Version 29). Statistical significance was set at P <0.05. RESULTS: SCT carriers (32.0%) were concentrated in the island regions and their corresponding ethnic groups. They were more likely to have microscopic P. falciparum infection than non-carriers in unstratified (odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.4-3.5) and age-stratified analyses (<5 years, OR = 2.3, 95% CI = 1.0-5.2; 15-24 years, OR = 5.0, 95% CI = 1.8-13.8). However, among infected children aged <5 years, they had lower parasitemia and higher hemoglobin levels. CONCLUSIONS: SCT offered protection against severe outcomes among young children but increased microscopic infection risk among older individuals, underscoring the paradox and complexity of SCT-mediated protective mechanisms and their relevance for host-targeted malaria elimination strategies.
Language: English
Topic: Malaria Research and Control
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W4415315592