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Title: The Relationship Between Haemoglobin E and Malaria in Southern Vietnam
Author: O'Riordan, Sean
Awarding Body: Open University
Current Institution: Open University
Date of Award: 2006
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Haemoglobin E is the most common single mutation haemoglobinopathy worldwide, presumably due to selective pressure from malaria. There is no good clinical data to support this hypothesis, however, and the laboratory data is conflicting. This thesis presents the results of prevalence studies, cross sectional association studies and a case control study undertaken to examine the relationship between haemoglobin E and malaria in southern Vietnam. The S'Ti€ng ethnic group demonstrated a high prevalence ofHbE and alpha thalassaemia, whilst the majority Kinh, and minorities from the north of Vietnam, had a low prevalence. The S'Ti€ng also appeared to experience a higher burden of malaria infection, as determined by malaria parasite point prevalence and the age pattern ofsevere disease. There was no association between haemoglobin E and malaria in the cross sectional surveys once correction was made for ethnicity. A knowledge, attitudes and practice survey demonstrated a small difference in the proportion of S'Ti€ng using .. bednets compared to other ethnic groups, but no other significant differences to account for their higher malaria burden. Malaria control programmes, which had been very successful .:elsewhere in Vietnam, have seemed slow to take effect in the central and southern ~iJ;~};~:f·~:1,;~.~tI:hj~~hmds, particularly amongst ethnic minority groups. There appeared to be some ~~$;fi~ls~'?~.j&ic:(t~~s over the course of the study, however, with the result that recruitment to the case ~H''.?:iP'~l:;':;~·~C(?p.trdl sUldy of severe malaria was slow, and there were insufficient cases from l;:/~i¥:f:':;PQl)liI;~ti(ms with high prevalences of haemoglobin E to draw any firm conclusions. The ~i:~j0~;~I~~~'g,lthl~red demonstrate a trend towards susceptibility to moderate and severe disease ffiljt~~i~1[W~~~~f~falgethe:r, however, suggesting that any protective effect is likely to be modest.
Supervisor: Not available Sponsor: Not available
Qualification Name: Open University, 2006 Qualification Level: Doctoral
EThOS ID:  DOI: Not available