Serum ferritin and other haematological measurements in apparently healthy adults with malaria parasitaemia in Lagos, Nigeria

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Abstract
Summary: We studied 300 apparently healthy residents of Lagos aged 16–57 years. Their mean ferritin levels were 99.6 ± 50.5 µg/l (men aged 20–57) and 66.5 ± 44 µg/l (women aged 20–53) in aparasitaemic individuals. In parasitaemic subjects, mean ferritin levels were 133.1 ± 48.3 µg/l (men aged 20–56) and 114.8 ± 51.1 µg/l (women aged 16–50). Mean haematocrit values for aparasitaemic males were 45.7 ± 5.6% and 37.9 ± 5% for females, while mean haemoglobin levels were 153.2 ± 1.5 µg/l and 124 ± 3 µg/l, respectively. The mean values for MCV (mean corpuscular volume), MCH (mean corpuscular haemoglobin) , MCHC (mean corpuscular haemoglobin concentration) were 101.7 ± 8 fl, 30.6 ± 2.2 pg, 335 ± 0.4 g/l and 99.8 ± 10.1fl, 29.1 ± 6.5 pg, 335 ± 6 g/l. Serum iron levels were 34.2 ± 5 µmol/l and 29.5 ± 7.7 µmol/l. All haematological parameters measured were similar in both malaria parasitaemia positive and negative subjects, except ferritin level which was significantly higher in parasitaemic individuals (P < 0.05). Ferritin concentration and malaria density (r = 0.76 in males, r = 0.74 in females, P < 0.05) were positively correlated. Ferritin levels of subjects infected with Plasmodium falciparum were significantly higher than of those infected with P. malariae (P < 0.05). Hence ferritin estimation without examination for malaria parasitaemia in a malaria‐endemic region such as Nigeria is not reliable. Asymptomatic malaria parasitaemia increases the ferritin level. Considering the mean ferritin level we found in normal subjects on a balanced diet, routine iron supplementation may not be necessary in the treatment of malaria‐induced anaemia in Nigeria.