Table 1.
Demographic, clinical, and laboratory characteristics of the study participants
| Characteristics | Aparasitemic (MPS Negative) | non-SMA (Hb ≥ 5.0 g/dL) | SMA (Hb < 5.0 g/dL) | P value |
|---|---|---|---|---|
| No. of participants (n = 1081) | 261 | 670 | 150 | |
| Sex, n (%) | ||||
| Male | 129 (49.4) | 345 (51.5) | 68 (45.3) | 0.381a |
| Female | 132 (50.6) | 325 (48.5) | 82 (54.7) | |
| Age (months) | 10.5 (12.7) | 13.8 (13.0) | 8.2 (9.2)*** | <0.001b |
| Glucose (mmol/L) | 5.0 (1.2) | 5.2 (1.6) | 5.2 (1.7) | 0.002b |
| Admission temperature (°C) | 37.0 (1.5) | 37.9 (1.9) | 37.5 (1.6) ** | <0.001b |
| Hematological parameters | ||||
| Hemoglobin (g/dL) | 10.3 (2.5) | 7.7 (2.9) | 4.4 (1.1)*** | <0.001b |
| Hematocrit (%) | 32.9 (6.4) | 25.0 (9.0) | 13.6 (3.5)*** | <0.001b |
| Red blood cells (×106/μL) | 4.7 (1.0) | 3.7 (1.4) | 1.9 (0.7)*** | <0.001b |
| Mean corpuscular volume (fL) | 69.7 (9.9) | 69.2 (11.8) | 72.8 (11.0)*** | <0.001b |
| Mean corpuscular hemoglobin (pg) | 22.3 (3.7) | 21.7 (3.8) | 22.7 (4.4)*** | <0.001b |
| Mean corpuscular hemoglobin concentration (g/L) | 31.8 (2.7) | 31.2 (2.6) | 31.6 (3.5) ** | 0.006b |
| Platelets (×103/μL) | 350.0 (220.0) | 153.0 (130.0) | 145.0 (101.0)*** | <0.001b |
| Mean platelet volume (fL) | 7.5 (1.5) | 8.1 (1.9) | 8.4 (1.5)* | <0.001b |
| WBCs (×103/μL) | 10.8 (7.5) | 11.2 (5.8) | 14.9 (9.7)*** | <0.001b |
| Lymphocytes (×103/μL) | 5.9 (4.2) | 5.0 (3.3) | 6.8 (5.2)* | <0.001b |
| Monocytes (×103/μL) | 0.8 (0.6) | 0.9 (0.8) | 1.6 (1.3)*** | <0.001b |
| Granulocytes (×103/μL) | 3.8 (3.1) | 5.0 (3.9) | 5.3 (4.9)** | <0.001b |
| Parasitological Indices | ||||
| Parasite density (MPS/μL) | 0.0 (0.0) | 25,891 (66,349) | 22,080 (55,516) | <0.001c |
| Geomean parasitemia (per μL) | 0 | 20,763 | 13,684* | <0.001d |
| HDP (≥10,000 parasites/μL), n (%) | 0 (0) | 460 (68.7) | 94 (62.7) | <0.001a |
| Genetic Variants | ||||
| Sickle cell trait, n (%) | 48 (18.8) | 114 (17.1) | 16 (10.7)** | 0.011a |
| G6PD deficiency, n (%) | 10 (4.4) | 32 (5.3) | 8 (5.5) | 0.235a |
| α+-Thalassemia deletion, n (%) | 0.462a | |||
| −α3.7/αα | 62 (27.4) | 169 (28.5) | 34 (24.6) | |
| −α3.7/−α3.7 | 60 (26.5) | 125 (21.1) | 32 (23.2) | |
| Endemic Co-infections | ||||
| HIV-1 exposure, n (%) | 38 (14.7) | 93 (13.9) | 28 (18.8)** | 0.011a |
| HIV-1 positive, n (%) | 12 (4.6) | 18 (2.7) | 12 (8.1)*** | 0.007a |
| Bacteremia positive, n (%) | 26 (10.0) | 48 (7.2) | 14 (9.3) | 0.318a |
Data are the median (interquartile range; IQR) unless otherwise noted. Children (n = 1081) were categorized into aparasitemic controls (n = 261; no parasitemia) and according to the WHO definition of SMA (63), into either non-SMA (n = 670; Hb ≥ 5.0 g/dL) or SMA (n = 150; Hb < 5.0 g/dL).
Statistical significance determined by the Chi-square analysis.
Statistical significance determined by Kruskal Wallis test, and where significant differences were observed, pairwise comparisons between the non-SMA and SMA groups were performed using Mann–Whitney U tests.
Statistical significance determined by Mann–Whitney U test.
Statistical significance determined by Students t-test. Bold indicates P ≤ 0.050.
Represents significant pairwise comparisons between the non-SMA and SMA groups at P ≤ 0.050,
represents P < 0.01, and
represents P < 0.001. MPS malaria parasites; HDP High density parasitemia (≥10,000 parasites/μL); G6PD Glucose 6 phosphate dehydrogenase deficiency