Influence of haemoglobins S and C on predominantly asymptomatic Plasmodium infections in northern Ghana

Ina Danquah, Peter Ziniel, Teunis A. Eggelte, Stephan Ehrhardt, Frank P. Mockenhaupt

Research output: Contribution to journalArticlepeer-review


The haemoglobin (Hb) variants HbS and HbC protect against severe malaria. Yet, the influence particularly of HbC on asymptomatic or mild Plasmodium infection is not well established.In a dry season cross-sectional survey among 2108 children aged 0.5-9 years in the Northern Region of Ghana, Plasmodium species and density, as well as Hb, were analysed with respect to Hb genotypes. HbAC occurred in 19.7% and HbAS in 7.4% (HbSC, 0.8%; HbCC, 0.8%; HbSS, 0.3%). Overall, 56% of the children had microscopically visible parasitaemia. By PCR, P. falciparum, P. malariae, and P. ovale were present in 74.5%, 9.7%, and 5.5%, respectively. Febrile parasitaemia was rare (2.8%) but anaemia (Hb < 11. g/dL) frequent (59.3%). Children with HbAA and HbAC showed virtually identical malariometric parameters. In contrast, children with HbAS had significantly less parasitaemia, lower parasite densities, and a higher proportion of submicroscopic P. falciparum infection. Remarkably, in children with HbCC, P. malariae infection occurred in 37.5% (adjusted odds ratio (aOR), 5.8; 95% CI, 1.8-18.8) and P. ovale in 18.8% (aOR, 3.61; 95% CI, 0.97-13.5).In this population with predominantly asymptomatic Plasmodium infection, HbAC shows no discernible effect on malaria-related parameters. Homozygous HbC, in contrast, confers an increased risk of P. malariae infection which conceivably may modulate falciparum malaria.

Original languageEnglish (US)
Pages (from-to)713-719
Number of pages7
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Issue number11
StatePublished - Nov 2010
Externally publishedYes


  • Dry season
  • Ghana
  • Haemoglobin C
  • Malaria
  • Plasmodium malariae
  • Sickle

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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