Influence of hemoglobin E trait on the severity of falciparum malaria

To determine if hemoglobin E trait influences the course of acute malaria, adults hospitalized for the treatment of symptomatic infection with Plasmod ium falciparum were studied retrospectively. Forty-two patients with hemogl obin E trait were compared with 175 reference subjects who did not have hem oglobin E, beta-thalassemia, glucosed-phosphate dehydrogenase deficiency, o r oc-thalassemia. One patient (2.4%) with hemoglobin E trait had a severe c omplication of malaria by World Health Organization criteria (cerebral mala ria), while 32 subjects in the reference group (18.3%) had one or more seve re complications: cerebral malaria (n = 18), hyperparasitemia (n = 16), ren al failure(n = 10), and severe anemia(n = I) (P = .044 after adjustment for ethnic categories). The estimated odds of severe complications in the refe rence subjects were 6.9 times the odds in patients with hemoglobin E trait (95% confidence interval, 1.2-146.4), These results suggest that hemoglobin E trait may ameliorate the course of acute falciparum malaria.