An estimated 300,000 babies are born each year with severe Inherited Disorders of Hemoglobin (IDH). Despite major advances in the understanding of the molecular pathology, control, and management of the IDH thousands of infants and children with these diseases are dying due to the accessibility to appropriate medical care. In addition, as malaria has been the principal cause of early mortality in several parts of the world for much of the last 5000 years, as a result, it is the strongest force for selective pressure on the human genome. That is why, in the world, there is an overlap of malaria endemicity and IDH. Over the past twenty years several studies have shown that IDH such us hemoglobin and/or red cell membrane abnormalities confer resistance to malaria reducing hence the mortality during the first years of life. This has led to the selection of populations with IDH in malaria-endemic areas. This may explain the overlap between these two pathologies. This chapter aims to present the relationship between IDH and malaria susceptibility, make an overview of the current state of knowledge and the burden of IDH, and highlight steps that require to be taken urgently to improve the situation.
Part of the book: Human Blood Group Systems and Haemoglobinopathies
Genetic factors, including red blood cell polymorphisms, influence the severity of disease due to infection with Plasmodium falciparum (Pf). Studies show that these genetic factors associated with malaria susceptibility or resistance vary geographically, ethnically, and racially. We performed cross-sectional surveys in population living in rural villages from three ethnic groups. The blood group (BG) was determined genetically using two polymorphisms (rs8176719 and rs8176746). Out of 548 participants, 29.7% were Mossi, 38.2% were Fulani, and 32.1% were Rimaibe. The distribution of BG was, respectively, A: 25.5%, B: 26.6%, AB: 7.3%, and O: 40.5%. BG O was not only the common blood type overall, but was higher in Fulani (52.6%) than others. Fulani was associated with a reduced risk of infection and lower parasite densities than sympatric populations. The subjects with non-O blood were less susceptible to malaria infection. An association between ethnicity and malaria infection during the high transmission season as well as an association between the non-O blood group and malaria infections according to ethnicity was found. This was also true when ethnic groups were considered separately. Our results have demonstrated that the Fulani are not only less susceptible to Pf malaria infection, but when infected have lower parasite densities. Individuals with non-O blood are at lower risk of infection.
Part of the book: Blood Groups