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Malarial anemia (MA) is a multifactorial disease for which the complex etiological basis is only partially defined. The association of clinical, nutritional, demographic, and socioeconomic factors with parasitemia, anemia, and MA was determined for children presenting at a hospital in a holoendemic area of Plasmodium falciparum transmission in western Kenya. Parasitemia was not associated with malaria disease severity. In univariate logistic regression, fever was significantly associated with parasitemia, and wasting was associated with increased presentation of MA. Caretaker’s level of education and occupation were significantly correlated with parasitemia, anemia, and MA. Housing structure was also significantly associated with parasitemia and anemia. Bed net use was protective against parasitemia but not anemia or MA. Multivariate logistic regression models demonstrated that fever, mother’s occupation, and bed net use were associated with parasitemia. In the current study, none of the factors were associated with anemia or MA in the multivariate models.
Received March 15, 2005. Accepted for publication June 30, 2005.
Acknowledgments: We sincerely thank all the parents, guardians, and children who participated in this study. We are grateful to all the University of Pittsburgh-KEMRI staff; Clifford Obuya, David Ounah, Agneta Awuor, and Jackline Okumu for excellent technical support; Oscar Odunga, Florence Awuor, Josephine Osore, Perez Siambe, and Solace Amboga for clinical support; and Amos K’Ogal and Emma Moenga for data management support. We also thank the Siaya District Hospital staff and management for their support during this study. We are grateful to Dr. Davy Koech, Director of Kenya Medical Research Institute (KEMRI), for approving this manuscript for publication. Portions of this work were presented at the 53rd Annual Meeting of the American Society for Tropical Medicine and Hygiene (ASTMH), November 7–11 2004, Miami Beach, Florida (Abstract no. 715).
Financial support: This work was supported by grants from the National Institutes of Health [AI51305-02 (D.J.P.) and TW05884-02 (D.J.P.)].
* Address correspondence to Douglas J. Perkins, Department of Infectious Diseases and Microbiology, University of Pittsburgh, 603 Parran Hall, 130 DeSoto St., Pittsburgh, PA 15261. E-mail: djp{at}pitt.edu
Authors’ addresses: John Michael Ong’echa, Collins Ouma, and Richard O. Otieno, University of Pittsburgh/KEMRI Laboratories of Parasitic and Viral Diseases, Kenya Medical Research Institute, Centre for Vector Biology and Control Research, P.O. Box 1578, Kisumu, Kenya. Tom Were and Alloys S. Orago, Department of Health Sciences, Kenyatta University, P.O. Box 43844, Nairobi, Kenya. George A. Ogonji, Ministry of Health, Siaya District Hospital, P.O. Box 144, Siaya, Kenya. John M. Vulule, Kenya Medical Research Institute, Centre for Vector Biology and Control Research, P.O. Box 1578, Kisumu, Kenya. Sandra S. Kaplan, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA. Richard D. Day, Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA. Christopher C. Keller, Zachary Landis-Lewis, Daniel Ochiel, Jamie L. Slingluff, and Douglas J. Perkins, Department of Infectious Diseases and Microbiology, University of Pittsburgh, 603 Parran Hall, 130 DeSoto St., Pittsburgh, PA 15261, Telephone: 412-624-5894, Fax: 412-624-4953, E-mail: djp{at}pitt.edu.
Reprint requests: Douglas J. Perkins, University of Pittsburgh Graduate School of Public Health, Department of Infectious Diseases and Microbiology, 603 Parran Hall, 130 DeSoto St., Pittsburgh, PA 15261.
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