Bedeutung von Koinfektionen mit Plasmodium falciparum und Parvovirus B19 für Fieber, Anämie und Krankenhausaufenthalt bei Kindern in Ghana

Human parvovirus B19 (B19V) occurs globally, causes erythema infectiosum but can also lead to severe anaemia. Children in malaria-endemic areas are a vulnerable population, for which the role of co-infections has been controversially discussed. The study aimed to determine prevalence and severity of B19V infection, and the effect of co-infections with the malaria parasite Plasmodium falciparum (P. falciparum) on the risk for anaemia.

Between November 2013 and April 2015, a total of 1.186 hospital visits of children with fever admitted to a hospital in Ghana were recorded. Malaria, B19V and additional diagnostics for fever causes were performed. Recent B19V infection was defined as PCR and/or IgM positivity. Risk factors for B19V infection and for anaemia were analysed.

B19V-IgM/-PCR was positive in 6.4 % (n = 76; 40 IgM+, 30 PCR+, 6 IgM+ and PCR+). Among the B19V cases 60.5 % had a simultaneous P. falciparum infection. A total of 598 (50,5 %) children presented with anaemia. B19V IgM positivity was associated with anaemia (OR = 2.6; 95-%-CI: 1.3-5.3; p < 0.01), while B19V PCR positivity did not increase the risk for anaemia. P. falciparum and IgM positive B19V infection were independent risk factors for anaemia. A multiplicative effect of the infections was not found. A low socioeconomic status was the main risk factor for a B19V infection. The clinical presentation of B19V was heterogenous.

We found high discordancy between performed serological assays as well as a small number of samples with positive IgM and PCR results. Hence possible reasons and adequate laboratory diagnostics in malaria-endemic regions in sub-Saharan Africa were discussed. Prior to further investigation validation of existing assays in sub-Saharan Africa, including testing for sensitivity of detection of different viral genotypes and possible interaction in malaria-endemic areas should be performed.


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