Date Published: July 9, 2020
Publisher: F1000 Research Limited
Author(s): Abdul-Hakim Mutala, Kingsley Badu, Christian Owusu, Samuel Kekeli Agordzo, Austine Tweneboah, Dawood Ackom Abbas, Matthew Glover Addo.
Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana.
Malaria remains the most important protozoan infection of humans and continues to have an immense impact on the health and quality of life of people across the world. Despite the decrease in incidence of mortality due to malaria in the last decade, the most recent World Malaria Report revealed that 228 million clinical cases of malaria were reported, resulting in no less than 405,000 deaths, the majority of which were in sub-Saharan Africa
We carried out a cross-sectional study targeting hospital attendees. In order to avoid bias and avoid including only ‘sick’ or symptomatic participants, we extended our sampling to include ‘healthy’ participants who accompanied their relatives or friends to the hospital.
In total, 598 participant samples were examined for parasite prevalence and density. A further 19 samples were excluded from the haematological analysis because the haematological indices could not be determined.
Table 1 gives a summary of the demographic profile of the study population.
We investigated the effect of malaria on haematological parameters of people in three different demographic settlements: urban, peri-urban and rural communities. By 2050, it is predicted that 58% of people in sub-Saharan Africa will be living in urban areas, compared with approximately 40% currently
17. This is expected to have a significant impact on the prevalence and clinical outcomes of infectious diseases like malaria as the increasing urban population further widens urban-rural economic and resource divides. In this study, people from the rural area recorded the highest prevalence of malaria compared to people from the urban and peri-urban areas, a finding that is consistent with results from other studies conducted in Ghana
19. Rural areas are often described as intense and perennial transmission areas as there are often several suitable
Anopheles breeding sites available, coupled with poor access and/or adherence to vector control measures by rural inhabitants
21. The relatively younger age observed in the rural area may also be a contributing factor to the high prevalence observed in this study area, as children represent a high risk group for malaria infection
22. In line with this, the majority of infected individuals in the rural area were children less than five years. Children under five years may not have a fully developed immune system and are, therefore, more susceptible to infections. Adults, on the other hand, have relatively stronger immune systems and often have partial immunity to malaria from previous exposure
23. This might explain why the older generation recorded the lowest parasite densities.