An Investigation of the Protective Effect of Alpha Plus -Thalassaemia Against Severe Plasmodium Falciparum Amongst Children in Kumasi, Ghana

SummaryIntroductionSeveral factors influence the severity of Plasmodium falciparum; here, we investigate the impact of alpha+‐thalassaemia genotype on P. falciparum parasitemia and prevalence of severe anaemia amongst microcytic children from Kumasi, Ghana.MethodsSeven hundred and thirty‐two children (≤10 years) with P. falciparum were categorised into normocytic and microcytic (mean cell volume ≤76 fL). Microcytic individuals were genotyped for the −α3.7deletional thalassaemia mutation and parasite densities determined.ResultsAmongst microcytic patients both parasite densities and prevalence of severe malaria parasitemia (≥100 000/μL) were significantly lower (P < 0.001) in the presence of an alpha+‐thalassaemia genotype compared with non‐alpha+‐thalassaemia genotype. There was no evidence that alpha+‐thalassaemia protected against severe anaemia. The protection conferred by alpha‐thalassaemia genotype against severe P. falciparum parasitemia did not change with increasing age.ConclusionThe severity of P. falciparum parasitemia was significantly lower in both the homozygous and heterozygous alpha+‐thalassaemia groups compared with microcytic individuals with non‐alpha+‐thalassaemia genotype. The protective effect, from severe malaria, of the alpha+‐thalassaemia allele does not alter with age.