A Comparative Study to Assess the Effect of Antimalarials on the Hemoglobin Levels of Children in the Kassena Nankana District of Ghana

Abstract

Background: Malaria associated anemia is a major problem in malaria endemic areas, especially among children five years and below. Studies have shown that treating children with uncomplicated malaria with efficacious antimalarial drugs clears parasites, which prevents the depletion of red blood cells and thereby improving the Hb concentration levels. No study has been conducted in the Kassena-Nankana District of northern Ghana to determine the effect of antimalarial on the Hb of children which is a malaria endemic area. Method: The study is secondary data analysis of a comparative open label efficacy study which was conducted at a time that chloroquine was failing in terms of parasitological cure. 351 children aged five and below were randomized into the primary study with AQ (116), CQ (120) and SP (114). This current study used paired t-test and unpaired t-test to compare mean Hbs in the various treatment groups. The primary objective of this study was to determine the effect of treating children with uncomplicated malaria with antimalarial drugs on their Hbs. Results: Generally mean Hbs in the various treatment groups declined on day 7 as compared to day 0 and also improved on day 28 as compared to day 0. Mean Hb level increased significantly on day 28 for AQ (0.65g/dl) with p-value 0.006 and SP (0.8g/dl) with p-value 0.001, but did not significantly improve for CQ (0.38g/dl). Males performed better in terms of improvement in mean Hb than females, with SP group (0.82g/dl) recording the highest improvement as compared to CQ (0.66g/dl) and AQ (0.18g/dl). Age group 13-36 months generally had the highest improvement in mean Hb with SP (0.82g/dl) group recording the highest in that age group as compared to AQ (0.52g/dl) and CQ (0.44g/dl). Conclusion: It is clear that prompt and effective treatment of malaria with effective fast- acting antimalarial drugs rapidly reduces symptomatic parasitemia and this allows red blood cells numbers to be restored thereby improving the hemoglobin level and consequently preventing anemia.