What should ones attitude be regarding adult sickle cell traits and malaria?
A 8: Sickle traits (children and adults with AS phenotype) do suffer from malaria, though with less complications, and they need protection as others. Adults resident in highly malarious regions develop some kind of immunity against malaria whether they are AA or AS. The spleen which helps in producing immunity is usually shrunken in adult SS people, so they should always be doubly protected in malarious regions with prophylactic drugs and mosquito nets, as should other sickle cell disease phenotypes. Health workers in Europe and USA have been known to tell Africans with sickle cell anaemia [SS] travelling back to their malarious countries that they do not need anti-malarial cover because they are already protected by sickling. This is highly dangerous advice based on ignorance, because such patients have been known to return to the temperate zone, suffer devastating sickle crisis, and hardly anyone has thought of excluding malarial parasitaemia as the precipitating cause of the crisis
