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Malaria-Related Anemia in Patients from Unstable Transmission Areas in Colombia

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  • Caucaseco Scientific Research Center, Cali, Colombia; Institute of Bioinformatics, University of Georgia, Athens, Georgia; Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia; Faculty of Health, Universidad del Valle, Cali, Colombia

Information about the prevalence of malarial anemia in areas of low-malaria transmission intensity, like Latin America, is scarce. To characterize the malaria-related anemia, we evaluated 929 malaria patients from three sites in Colombia during 2011–2013. Plasmodium vivax was found to be the most prevalent species in Tierralta (92%), whereas P. falciparum was predominant in Tumaco (84%) and Quibdó (70%). Although severe anemia (hemoglobin < 7 g/dL) was almost absent (0.3%), variable degrees of non-severe anemia were observed in 36.9% of patients. In Tierralta, hemoglobin levels were negatively associated with days of illness. Moreover, in Tierralta and Quibdó, the number of previous malaria episodes and hemoglobin levels were positively associated. Both Plasmodium species seem to have similar potential to induce malarial anemia with distinct cofactors at each endemic setting. The target age in these low-transmission settings seems shifting toward adolescents and young adults. In addition, previous malaria experience seems to induce protection against anemia development. Altogether, these data suggest that early diagnosis and prompt treatment are likely preventing more frequent and serious malaria-related anemia in Colombia.

Author Notes

* Address correspondence to Myriam Arévalo-Herrera, Caucaseco Scientific Research Center, Carrera 37-2Bis No. 5E-08, Cali, Colombia. E-mail: marevalo@inmuno.org

Financial support: This work was sponsored and conducted in sites affiliated with the Centro Latino Americano de Investigación en Malaria sponsored by The National Institute of Allergy and Infectious Diseases/International Centers of Excellence for Malaria Research (NIAID/ICEMR) Grant 1U19AI089702, Colciencias Grants 360-2011, 458-2012, and 719-2013, and Colombian Presidential Agency of International Cooperation Grant 045-2013. A.M. was supported by NIAID Grants R21AI094402-01 and R21AI095718-01.

Authors' addresses: Mary Lopez-Perez, Álvaro Álvarez, Sócrates Herrera, and Myriam Arévalo-Herrera, Caucaseco Scientific Research Center, Cali, Colombia, E-mails: marlopez@inmuno.org, aalvarez@inmuno.org, sherrera@inmuno.org, and marevalo@inmuno.org. Juan B. Gutierrez, Institute of Bioinformatics, University of Georgia, Athens, GA, E-mail: jgutierr@uga.edu. Alberto Moreno, Emory Vaccine Center, Yerkes National Primate Research Center and Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, E-mail: camoren@emory.edu.

Reprint requests: Myriam Arévalo-Herrera, Caucaseco Scientific Research Center, Carrera 37-2Bis No. 5E-08, Cali, Colombia, E-mail: marevalo@inmuno.org.

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