Study to Understand Resistance to Malaria in Ghana
The Kumasi College of Technology was founded in 1952 from 200 Teacher Training students transferred from Achimota to form the nucleus of the new College. This became a full-fledged University in 1961 and is now known as The Kwame Nkrumah University of Science and Technology, Kumasi (KNUST). The Komfo Anokye Hospital based in Kumasi is a full medical teaching hospital and is affiliated to the University.
Kumasi is the second largest city in Ghana with a population of 1.2 million. It is located within the Ashanti region of Ghana and has a semi-humid tropical climate with its peak rainfall between April and June. The primary malaria parasite is Plasmodium falciparum and appears to vary markedly between communities with prevalence estimates in children varying between 4 and 30%. Bednet and mosquito repellants are reported to be regularly used.
In a study in two communities in Kumasi, Ashanti region namely Aframanaso and Kona, Annual Biting Rates (ABRs) and Annual Entomological Inoculation Rates (AEIRs) were much higher at Afamanaso (11,643 vs. 866) than at Kona (5,329 vs. 490). Most of the transmission (91.4%) occurred during bedtime hours from 21 to 6 h. It is important to note that there was still a substantial transmission before 21 h with AEIRs of 57.3 at Afamanso and 38.7 at Kona. The distribution of impregnated bednets alone, therefore, may not be sufficiently effective.
Description of study population - Cases
Children aged from 3 months to 12 years admitted to the Paediatric Emergency Unit of Komfo Anokye Teaching Hospital with severe malaria were recruited after obtaining consent from parents or guardians from August 2006 to December 2008.
The emergency unit is the first point of call for all paediatric related cases above 3 months of age. Being the only Teaching Hospital and main referral center in the Middle to Upper zone of Ghana, we treat children with diverse ethnic, socioeconomic, and religious background in the unit.
Description of study population - Controls
Cord blood samples from the labour ward of the same hospital were used as community controls. Biological parents of children with malaria were also requested after informed consent to give 2mls of blood for genetic analysis.