The Prevalence of α-Thalassemia and Its Relation to Plasmodium falciparum Infection in Patients Presenting to Clinics in Two Distinct Ecological Zones in Ghana

Abstract

Thalassemia and sickle cell disease constitute the most monogenic hemoglobin (Hb) disorders worldwide. Clinical symptoms of a+-thalassemia (a+-thal) are related to inadequate Hb production and accumulation of b- and/or g-globin subunits. The association of thalassemia with malaria remains contentious, though from its distribution it appears to have offered some protection against the disease. Data on the prevalence of thalassemia in Ghana and its link with malaria is scanty and restricted. It was an objective of this cross-sectional study to determine the prevalence of thalassemia in areas representing two of Ghana’s distinct ecological zones. The relationship between thalassemia and Plasmodium falciparium (P. falciparum) infection was also ascertained. Overall, 277 patients presenting to health facilities in the study areas were recruited to participate. Tests were carried out to determine the presence of a+-thal, sickle cell and malaria parasites in the blood samples of participants. The outcome of this study showed an a+-thal frequency of 19.9% for heterozygotes ( a/aa) and 6.8% for homozygotes ( a/ a). Plasmodium falciparum was detected in 17.7% of the overall study population and 14.9% in those with a+-thal. No association was observed between those with a+-thal and the study sites (p40.05). A test of the Hardy-Weinberg law yielded no significant difference (p50.001). Findings from this study suggest a modest distribution of a+-thal in Ghana with no bias to the ecological zones. Although the prevalence and parasite density were relatively low in those with the disorder, no association was found between them.