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Blood Lead alters the anemia status of malaria infected children in Katanga Kampala Uganda.


 Background Uganda, like other malaria endemic countries, childhood anemia due to malaria infection, malnutrition and social disadvantages remains a health challenge. Other contributing factors towards the pathogenesis of this disease like blood lead have not been fully explored. Persistent lead exposure accounts for one’s blood lead levels and other many health outcomes. Recent studies report elevated environmental lead levels in urban Uganda with anthropogenic activities including leaded paints, leaded fuels spillages, lead-contaminated air, water and soils listed as major sources. Blood lead (BL) alters iron bioavailability by competitively blocking iron absorption hence anemia. BL inhibits key enzymes ferrochelatase and aminolevulinic acid dehydratase (ALAD) involved in hemoglobin (Hb) biosynthesis resulting into elevated free erythrocyte protoporphyrin (FEP). Children in this area are generally anemic due chronic exposure to malaria parasites that thrive on their red blood cells for survival. Concomitant exposure to both malaria infection and lead pollution, exerbates the anemia status of these children. This study therefore aimed at expounding the anemia status of these Ugandan children simultaneously living exposed to both malaria infection and environmental lead pollution. Methods Briefly venous blood samples from 198 children were microscopically assayed for malaria parasite density, hemoglobin (Hb) concentrations by the cyanmethemoglobin method, BL levels by the standard atomic absorption spectrophotometric method and FEP levels by the standard fluorimetric method. Results A total of 151/198 (76.3%) children were analyzed with moderate anemia (Hb <10>5 g/dL) while 8/198 (4%) had severe anemia (<5 g/dL). They had means of BL levels (9.3 µg/dL), Hb (7.5 g/dL), FEP/Hb (8.3 µg/g) and parasite density (PD) (3.21×103 parasites / µL). There was weak negative correlation between PD and Hb (r = -0.231, R2= 0.15 P-value < 0.001), as compared to that between FEP/Hb and Hb (r = -0.6, R2=0.572 P-value=0.001). Conclusion Basing on this study’s findings, we conclude that BL is a significant contributor to anemia pathogenesis and therefore its co-existence with plasmodium malaria infection in the host exerbates the anemia status.Trial registration Not applicable