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Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire

BACKGROUND: Although potential links between malaria parasitaemia and hypertension have been hypothesized, there is paucity of epidemiologic evidence on this link. We investigated in a population-based survey, the association between malaria parasitaemia and hypertension in Ivorian adults. METHODS:...

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Autores principales: Eze, Ikenna C., Bassa, Fidèle K., Essé, Clémence, Koné, Siaka, Acka, Félix, Laubhouet-Koffi, Véronique, Kouassi, Dinard, Utzinger, Jürg, Bonfoh, Bassirou, N’Goran, Eliézer K., Probst-Hensch, Nicole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587219/
https://www.ncbi.nlm.nih.gov/pubmed/30801386
http://dx.doi.org/10.1097/HJH.0000000000002071
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author Eze, Ikenna C.
Bassa, Fidèle K.
Essé, Clémence
Koné, Siaka
Acka, Félix
Laubhouet-Koffi, Véronique
Kouassi, Dinard
Utzinger, Jürg
Bonfoh, Bassirou
N’Goran, Eliézer K.
Probst-Hensch, Nicole
author_facet Eze, Ikenna C.
Bassa, Fidèle K.
Essé, Clémence
Koné, Siaka
Acka, Félix
Laubhouet-Koffi, Véronique
Kouassi, Dinard
Utzinger, Jürg
Bonfoh, Bassirou
N’Goran, Eliézer K.
Probst-Hensch, Nicole
author_sort Eze, Ikenna C.
collection PubMed
description BACKGROUND: Although potential links between malaria parasitaemia and hypertension have been hypothesized, there is paucity of epidemiologic evidence on this link. We investigated in a population-based survey, the association between malaria parasitaemia and hypertension in Ivorian adults. METHODS: We estimated the adjusted odds ratios (OR) and 95% confidence intervals (CI) of hypertension in relation to malaria parasitaemia using multinomial regression, in 997 randomly selected adults in the ‘Côte d’Ivoire Dual Burden of Disease Study’ (CoDuBu), in south-central Côte d’Ivoire. We defined malaria parasitaemia as a positive rapid diagnostic test or identification of Plasmodium spp. on microscopy. Using the mean of the last two of three blood pressure (BP) measurements and questionnaire data, we defined hypertension as SBP at least 140 mmHg or DBP at least 90 mmHg or clinician-diagnosed hypertension. RESULTS: Prevalence of malaria parasitaemia and hypertension were 10 and 22%, respectively. Malaria parasitaemia was negatively associated with hypertension in participants with body temperature 36.5 °C or less [OR 0.23 (95% CI 0.06–0.84)]. Contrastingly, microscopic malaria parasitaemia showed positive associations with hypertension in participants with elevated body temperature [>36.5 °C; OR: 2.93 (95% CI 0.94–9.14)]. Participants having microscopic malaria parasitaemia with elevated body temperature had three-fold higher odds of hypertension [OR: 3.37 (95% CI 1.12–10.0)] than malaria parasitaemia-negatives with lower body temperature. CONCLUSION: Malaria parasitaemia and hypertension are prevalent and seemingly linked comorbidities in African settings. This link may depend on malaria parasitaemia symptomaticity/latency where individuals with more latent/asymptomatic malaria parasitaemia have lower risk of hypertension and those with more acute/symptomatic malaria parasitaemia have a tendency toward higher BP. The cross-sectional nature of the study limited the distinction of short-term BP elevation (interim pathophysiological stress) from hypertension development. Future longitudinal studies considering malaria/hypertension phenotypes and host molecular variations are needed to clarify involved biological mechanisms, toward comorbidity management.
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spelling pubmed-65872192019-07-22 Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire Eze, Ikenna C. Bassa, Fidèle K. Essé, Clémence Koné, Siaka Acka, Félix Laubhouet-Koffi, Véronique Kouassi, Dinard Utzinger, Jürg Bonfoh, Bassirou N’Goran, Eliézer K. Probst-Hensch, Nicole J Hypertens ORIGINAL PAPERS: Epidemiology BACKGROUND: Although potential links between malaria parasitaemia and hypertension have been hypothesized, there is paucity of epidemiologic evidence on this link. We investigated in a population-based survey, the association between malaria parasitaemia and hypertension in Ivorian adults. METHODS: We estimated the adjusted odds ratios (OR) and 95% confidence intervals (CI) of hypertension in relation to malaria parasitaemia using multinomial regression, in 997 randomly selected adults in the ‘Côte d’Ivoire Dual Burden of Disease Study’ (CoDuBu), in south-central Côte d’Ivoire. We defined malaria parasitaemia as a positive rapid diagnostic test or identification of Plasmodium spp. on microscopy. Using the mean of the last two of three blood pressure (BP) measurements and questionnaire data, we defined hypertension as SBP at least 140 mmHg or DBP at least 90 mmHg or clinician-diagnosed hypertension. RESULTS: Prevalence of malaria parasitaemia and hypertension were 10 and 22%, respectively. Malaria parasitaemia was negatively associated with hypertension in participants with body temperature 36.5 °C or less [OR 0.23 (95% CI 0.06–0.84)]. Contrastingly, microscopic malaria parasitaemia showed positive associations with hypertension in participants with elevated body temperature [>36.5 °C; OR: 2.93 (95% CI 0.94–9.14)]. Participants having microscopic malaria parasitaemia with elevated body temperature had three-fold higher odds of hypertension [OR: 3.37 (95% CI 1.12–10.0)] than malaria parasitaemia-negatives with lower body temperature. CONCLUSION: Malaria parasitaemia and hypertension are prevalent and seemingly linked comorbidities in African settings. This link may depend on malaria parasitaemia symptomaticity/latency where individuals with more latent/asymptomatic malaria parasitaemia have lower risk of hypertension and those with more acute/symptomatic malaria parasitaemia have a tendency toward higher BP. The cross-sectional nature of the study limited the distinction of short-term BP elevation (interim pathophysiological stress) from hypertension development. Future longitudinal studies considering malaria/hypertension phenotypes and host molecular variations are needed to clarify involved biological mechanisms, toward comorbidity management. Lippincott Williams & Wilkins 2019-07 2019-02-18 /pmc/articles/PMC6587219/ /pubmed/30801386 http://dx.doi.org/10.1097/HJH.0000000000002071 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle ORIGINAL PAPERS: Epidemiology
Eze, Ikenna C.
Bassa, Fidèle K.
Essé, Clémence
Koné, Siaka
Acka, Félix
Laubhouet-Koffi, Véronique
Kouassi, Dinard
Utzinger, Jürg
Bonfoh, Bassirou
N’Goran, Eliézer K.
Probst-Hensch, Nicole
Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title_full Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title_fullStr Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title_full_unstemmed Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title_short Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d’Ivoire
title_sort epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural côte d’ivoire
topic ORIGINAL PAPERS: Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6587219/
https://www.ncbi.nlm.nih.gov/pubmed/30801386
http://dx.doi.org/10.1097/HJH.0000000000002071
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