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Red cell morphology and malaria anaemia in children with Southeast‐Asian ovalocytosis band 3 in Papua New Guinea
Author(s) -
A. O’Donnell,
SJ Allen,
Mgone Cs,
Jeremy Martinson,
Clegg Jb,
D. J. Weatherall
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00742.x
Subject(s) - plasmodium falciparum , malaria , band 3 , biology , new guinea , red cell , thalassemia , immunology , genetics , medicine , erythrocyte membrane , history , ethnology , membrane
Southeast‐Asian ovalocytosis (SAO) was diagnosed in children from Madang, Papua New Guinea, by detection of the SAO band 3 gene variant using the polymerase chain reaction. SAO band 3 was present in 16/241 (6.6%) children living in the community and 32/389 (8.2%) children with acute Plasmodium falciparum malaria ( P = 0.42). SAO band 3 was detected in 8.2% (23/281) of α + ‐thalassaemia homozygotes, 9.4% (20/214) of heterozygotes and 2.4% (2/85) of children with a normal α‐globin genotype ( P = 0.12). The most consistent feature of SAO band 3 on microscopy of thin blood films was red cells with two or more linear or irregularly‐shaped pale regions. In children living in the community, these were present in 15 with SAO band 3 (sensitivity 93.8%) and only two normals (specificity 99.1%). The presence of 20% ovalocytosis was a poorer indicator of SAO band 3 (sensitivity 68.8% and specificity 100%). Haematological data were similar in SAO band 3 and normal children. However, in children with acute malaria, haemoglobin levels and red cell counts were significantly lower in SAO band 3 than normal children. The degree of ovalocytosis was lower in children with SAO band 3 during acute malaria, suggesting that a selective loss of ovalocytes may contribute to malaria anaemia in Southeast‐Asian ovalocytosis.