Anda di halaman 1dari 7

www.ijpbs.

net

Internationally indexed journal


Indexed in Chemical Abstract Services (USA), Index coppernicus, Ulrichs Directory of Periodicals,
Google scholar, CABI ,DOAJ , PSOAR, EBSCO , Open J gate , Proquest , SCOPUS , EMBASE ,etc.

Rapid and Easy Publishing


The International Journal of Pharma and Bio Sciences (IJPBS) is an international journal in English
published quarterly. The aim of IJPBS is to publish. peer reviewed research and review articles rapidly
without delay in the developing field of pharmaceutical and biological sciences

Indexed in Elsevier Bibliographic Database ..


(Scopus and EMBASE)
SCImago Journal Rank 0.288
Impact factor 2.958*

ISSN 6299 -0975

Chemical Abstracts
Service (www.cas.org)

CODEN IJPBJ2

Elsevier
evier Bibliographic databas
tabases
(Scopus & Embase)
SNIP value 0.77
SJR - 0.288
IPP - 0.479
SNIP Source normalised impact per
er p
paper
SJR SCImago Journal rank
IPP Impact per publication
Source www.journalmetrics.com
(Powered by scopus (ELSEVIER)

And indexed/catalogued in
n
many more university

*Instruction to Authors
Autho visit www.ijpbs.net
For any Queries,
ries, vvisit contact of www.ijpbs.net

Int J Pharm Bio Sci 2015 April; 6(2): (B) 1106 - 1110

Research Article

Microbiology

International Journal of Pharma and Bio Sciences

ISSN
0975-6299

ANAEMIA & PARASITISM: DO THEY GO HAND IN HAND?


VINAY KHANNA1*, KRITI TILAK1, RUCHEE KHANNA2
AND CHIRANJAY MUKHOPADHYAY1
1

Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

ABSTRACT
Anaemia is considered as the chief cause of iron deficiency in the body which is the
most prevalent nutritional deficiency throughout the world. Anaemia accounts for
significant morbidity particularly in underdeveloped countries. Parasitic infestations are
among the leading health problems in resource poor countries due to poor hygienic
conditions. In the present study we aim to analyse association between anaemia and
parasitism. We found that the leading parasites causing blood loss and hence resulting
in anaemia are hookworm, whipworm, Giardia lamblia and Blastocystis hominis. We
therefore conclude a positive association between parasitism and anaemia.
KEYWORDS: Anaemia, Parasitic diseases,

*Corresponding author

VINAY KHANNA
Department of Microbiology, Kasturba Medical College,
Manipal University, Manipal, Karnataka, India

This article can be downloaded from www.ijpbs.net


B - 1106

Int J Pharm Bio Sci 2015 April; 6(2): (B) 1106 - 1110

INTRODUCTION
Parasitic infestations are among the leading
public health problems in underdeveloped
and developing countries, mainly because of
low socioeconomic status and poor sanitation
conditions prevalent in several regions of
these countries1. According to Rocha (2004),
poor hygiene conditions and measures for
public health education in combination with
low socioeconomic status are factors
responsible for increasing prevalence of
parasitic diseases and anaemia in this
population. In India, intestinal parasites are
common, especially among children and the
main consequences are: chronic diarrhoea,
poor absorption of nutrients, anaemia, low
attention
span
and
learning
disabilities.Anaemia is a blood related
disease caused by the decrease of
haemoglobin. It is considered as the leading
cause of iron deficiency in the body, the most
prevalent nutritional deficiency in the whole
world. Screening for iron deficiency anaemia
accompanying parasitic infestation is done by
determination of haemoglobin. Although some
studies could not establish a correlation
between parasites and anaemia1, other
authors have reported the presence of
intestinal
parasites
associated
with

appearance of anaemia2, and also with


deteriorating nutritional status, especially in
children1. Other authors observed a 26%
reduction in cases of anaemia in children
treated with anti-helminths3.It is estimated
that nearly half of the worlds children under
the age of four years, in developing countries,
are affected by anaemia.

AIMS AND OBJECTIVES


The aim of the present study was to examine
the relationships of haemoglobin (Hb)
concentration and anaemia with common
parasitic
infections,
including
malaria,
hookworm,
Ascaris
lumbricoides
and
Trichuris trichiura.

MATERIALS AND METHODS


A total of 625 cases attending tertiary care
center, diagnosed with various parasitic
infestations, over a period of 5 years, were
screened for low haemoglobin concentration.
Haemoglobin concentration 10 mg% was
taken into account. The data was analyzed
using 16.0 spss software.

RESULTS
Table 1
Age wise distribution of patients with various parasitic
infestations presenting with anaemia
Haemoglobin (in mg%)
Age (in years)
0-16
17-50
>50

<10
20
91
38

>10
46
334
96

This article can be downloaded from www.ijpbs.net


B - 1107

Int J Pharm Bio Sci 2015 April; 6(2): (B) 1106 - 1110

Figure 1
Age-wise distribution of patients with various parasitic infestations. (n=625)

Figure 2
Age-wise distribution of patients with various Plasmodium species infection (n=625)

This article can be downloaded from www.ijpbs.net


B - 1108

Int J Pharm Bio Sci 2015 April; 6(2): (B) 1106 - 1110

Figure 3
Relationship between positive cases of parasitic
infestation with anaemia (n=625)

Patients with various parasitic infestations presenting with


anaemia
No. of cases

50
45
40
35
30
25
20
15
10
5
0
Ent
am
oeb
a
hist
olyt
ica/
di

Bla Str
sto ong
Tric
cys yloi
ho
tis des
mo
ho ster
nas
min cor
is alis

Cys
tos
por
a
bell
i

Gia
rdi
a
lam
blia

Total no. of cases found positive for


17 17 44
parasite

17 10

17 25 33 14 26

No. of cases with haemoglobin


concentration <11 mg/dl

Ent
am
oeb
a
coli

Ho
ok
wo
rm

26

Tric
hur
is
tric
hiu
ra

Leis
hm
ani
a

23

Cry
Cyc
Cys Ech Tox
Sca
pto
los
tice ino opl Fila Asc
bie
spo
por
rco coc as ria aris
ridi
s
a
sis cus ma
um

Types of parasitic infestation


Total no. of cases found positive for parasite

No. of cases with haemoglobin concentration <11 mg/dl

Figure 4
Relationship between positive cases of various Plasmodium
species infection with anaemia (n=625)

This article can be downloaded from www.ijpbs.net


B - 1109

Int J Pharm Bio Sci 2015 April; 6(2): (B) 1106 - 1110

DISCUSSION
Figure 1 and figure 2 clearly show that agegroup 17-50 years is the most commonly
affected age-group as far as parasitic
infestations are concerned. These data have
to be better investigated, since, in literature
parasitic infestations are more commonly
associated with children. Figure 3 and figure 4
show that the leading parasites causing blood
loss in man and resulting in direct irondeficiency
anaemia
include
hookworm
infection
(Necator
americanus
and
Ancylostoma duodenale); whipworm infection
(Trichuris trichiura); Giardia lamblia and
Blastocystis hominis infection. Radioisotope
studies with chromium 51-tagged red blood
cells have shown that patients with heavy
hookworm infection can lose up to 250 ml of
blood, daily, and up to 29 mg of iron in the
gastrointestinal tract, thus leading to direct
iron-deficiency anaemia4. Workers from South
America and East Africa have made known
that each Necator americanus worm can
cause a daily blood loss of 0.03 ml, which
implies
that
patients
infected
with
approximately 1,000 worms can lose up to 30
ml of blood daily. Work from London and
Egypt has shown that the Old World
hookworm, Ancylostoma duodenale, can
cause a daily blood loss of 0.2 ml which is
approximately 10 times more than the
American hookworm, Necator americanus.
Layrisse and his colleagues, using 51Cr-

tagged red cells, measured the blood loss


caused by T. trichiura in heavily infected
children and showed that the daily blood loss
can reach up to 8.6 ml. These workers
concluded that infection of over 800 parasites
can lead to anaemia5. It has been shown by
51
Cr and body surface counting of radioactivity
that
the
large
spleen
in
chronic
schistosomiasis, leishmaniasis, and malaria,
can destroy the red blood cells and lead to
anaemia
secondary
to
hypersplenism.
Malabsorption syndrome leading to poor
absorption of essential nutrients may occur in
patients heavily infected with hookworms,
Strongyloides stercoralis and Giardia lamblia.
Destruction of red blood cells leading to a
haemolytic anaemia has been shown to occur
in malaria, and vitamin B12megaloblastic
anaemia has been demonstrated to occur in
patients infected with the intestinal fish worm,
Diphyllobothrium latum6.

CONCLUSION
The present study revealed that the leading
parasites causing blood loss and hence
resulting in anaemia are hookworm,
whipworm, Giardia lamblia and Blastocystis
hominis. It is therefore concluded that a
positive association exists between parasitism
and anaemia.

REFERENCES
1.

2.

3.

Tsuyuoka R., Bailey J.W., Guimares


Amdan Gurgel RQ, Cuevas Le. Anemia and
intestinal parasitic infections in primary
school students in Aracaju, Sergipe, Brazil
15: 413-421, (1999)
UNICEF. WHO. Preventing iron deficiency in
women and children: technical consensus on
key issues. New York: UNICEF/WHO 21,
(1998)
Guyatt H.l., Brooker S., Kihamia Cm, Hall A,
Bundy Dap. Evaluation of efficacy of schoolbased anthelmintic treatments against
anaemia in children in the United Republic of
Tanzania 79(8): 695-703, (2001).

4.

5.

6.

Roche, M., M. E. Perez-Gimenez, M.


Layrisse And E. Di Prisco. Study of urinary
and fecal excretion of radioactive chromium
Cr51 in man. Its use in the measurement of
intestinal blood loss associated with
hookworm infection. J. Clin. Invest. 36: 1183,
(1957).
Layrisse, M., N. Blumenfeld, I. Dugarte And
M. Roche. Vitamin B12 and folic acid
metabolism in hookworm infected patients.
Blood 14: 1269, (1959).
Nyberg, W. The influence of D. latum on the
vitamin B12 intrinsic factor complex.Acta Med.
Scand. 167: 185, (1960).

This article can be downloaded from www.ijpbs.net


B - 1110