Hemoglobin e and glucose-6-phosphate dehydrogenase deficiency and plasmodium falciparum malaria in the chittagong hill districts of Bangladesh

Kerry L. Shannon, Sabeena Ahmed, M Hafizur Rahman, Chai S. Prue, Jacob Khyang, Malathi Ram, M. Zahirul Haq, Ashish Chowdhury, Jasmin Akter, Gregory E. Glass, Timothy M Shields, Myaing M. Nyunt, Wasif A. Khan, David Allen Sack, David J Sullivan

Research output: Contribution to journalArticle


Hemoglobin E is largely confined to south and southeast Asia. The association between hemoglobin E (HbE) and malaria is less clear than that of hemoglobin S and C. As part of a malaria study in the Chittagong Hill Districts of Bangladesh, an initial random sample of 202 individuals showed that 39% and 49% of Marma and Khyang ethnic groups, respectively, were positive for either heterozygous or homozygous hemoglobin E. In this group, 6.4% were also found to be severely deficient and 35% mildly deficient for glucose-6-phosphate dehydrogenase (G6PD). In a separate Plasmodium falciparum malaria case-uninfected control study, the odds of having homozygous hemoglobin E (HbEE) compared with normal hemoglobin (HbAA) were higher among malaria cases detected by passive surveillance than age and location matched uninfected controls (odds ratio [OR] = 5.0, 95% confidence interval [CI] = 1.07-46.93). The odds of heterozygous hemoglobin E (HbAE) compared with HbAA were similar between malaria cases and uninfected controls (OR = 0.71, 95% CI = 0.42-1.19). No association by hemoglobin type was found in the initial parasite density or the proportion parasite negative after 2 days of artemether/lumefantrine treatment. HbEE, but not HbAE status was associated with increased passive case detection of malaria.

Original languageEnglish (US)
Pages (from-to)281-286
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number2
Publication statusPublished - Aug 1 2015


ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

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