The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children

Objective:To determin the extent to which parvovirus B19(B19V)and co-infection of B19V and malaria contribute to risk of anaemia in children.Methods:B19V DNA and malaria parasites were screened for 234 children at the PMI,Children’s Hospital in Accra.The role of B19V and coinfection with B19V and malaria in anaemia was evaluated by analysing full blood cell counts,malaria and B19V DNA results from these children.Results:The prevalence of B19V,malaria and co-infection with B19V and malaria was 4.7%,41.9%and 2.6%,respectively.Malaria posed a greater risk in the development of mild anaemia compared to severe anaemia(OR=5.28 vrs3.15)whereas B19V posed a higher risk in the development of severe anaemia compared to mild anaemia(OR=4.07 vrs 1.00)from a non-anaemic child.Persons with co-infection with B19V and malaria had 2.23 times the risk(95%CI=0.40-12.54)of developing severe anaemia should they already have a mild anaemia.The degree of anaemia was about three times affected by coinfection(Pillai’s trace=0.551,P=0.001)as was affected by malaria alone(Pillai’s trace=0.185,P=0.001).B19V alone did not significantly affect the development of anaemia in a non-anaemic child.Microcytic anaemia was associated with B19V and co-infection with B19V and malaria more than normocytic normochromic anaemia.Conclusions:B19V was associated with malaria in cases of severe anaemia.The association posed a significant risk for exacerbation of anaemia in mild anaemic children.B19V and co-infection with B19V and malaria may be associated with microcytic anaemia rather than normocytic normochromic anaemia as seen in cases of B19V infection among persons with red cell abnormalities.