Executive Summary : | Out of 520 patients admitted at V.S.S. Institute of Medical Sciences and Research, Burla with severe P. falciparum malaria, 402 (77.3%) patients had HbAA, 112 (21.5%) patients had sickle cell gene (66 patients with Sickle cell trait and 46 patients with sickle cell anemia), 6 patients had ?-thalassemia trait. Haematological parameters were comparable in patients with HbAA and HbAS, but found different from patients with HbSS. Patients with alpha thalassemia had higher hemoglobin and RBC level whereas lowered MCV, MCH and MCHC level compared to patients with normal alpha globin genotype. The mortality was higher in patients with normal genotypes compared to alpha thalassemia. There was increased hemoglobin and WBC level and decreased MCV, MCH and MCHC level in patients (HbAA) with alpha thalassemia compared to normal alpha globin genotypes. In patients with HbSS, none of the clinical sub-phenotypes of severe malaria was associated with alpha thalassemia except severe malarial anemia, which was higher in patients with alpha thalassemia compared to patients with normal alpha globin genotype. The presence of high CR1 level and high incidence of AA genotype (exon-22) and HH genotype (intron-27) of CR1 in cases with sickle cell gene (Both HbAS and HbSS) revealed, the rate of clearance of immune complexes was lowered in HbAA, intermediate in HbAS and higher in HbSS and hence provided protection to severe P. falciparum malaria. |