Can a sickle cell warrior get malaria?
There is a myth pervasive in the medical and sickle cell community that for some unknown reason sickle cell gives you immunity to malaria. This is NOT true! One of the worst childhood crisis I had was when I turned 12. It was triggered by malaria, and quickly derailed within a matter of days to where I was clinging for dear life!
Resistant is Different than Immune
Having sickle cell only makes you resistant to malaria. RESISTANT not IMMUNE. You have some protection, but it’s not 100% protection. Imagine you are in the rain with an umbrella that has holes in it. Will you get wet? Yes! The same concept applies to malaria. You can still get malaria, because not every single cell in your body is sickled. The non-sickled red blood cells can still get infected by the malaria plasmodium. In fact, because of the malaria attacking your ‘normal’ red blood cells and your sickled cells clumping and lysing (breaking apart), we are actually at a greater risk for tissue ischemia, organ damage (liver, kidneys, spleen etc.), and other health complications. On top of that, your spleen is responsible for getting rid of parasites in your body. Since sickle cell warriors often have no spleen, or we have a compromised spleen, this function cannot be completed. So where does that leave us? With malaria!
Trait Advantages
If you have sickle cell trait, you have a slight advantage because your body is just fighting the malaria infection on one front. Your red blood cells, due to the trait, have the rigid walls so plasmodium cannot easily enter the cell. Once the infection is over, those cells return to their usual round shape. This advantage is what confuses many people.
However, those of us with any variation of sickle cell disease (including thallasemia, hemoglobin SE, SC, SF etc.), are at a greater disadvantage. Our sickled red blood cells cannot carry enough oxygen to our tissues because they are deficient. Plus in times of stress, they clump and cause blockages in our blood vessels. And our regular red blood cells are being infected with malaria and dying left and right. So essentially, you have no good cells in this scenario. Which spells trouble.
So please, those of you in tropical climates where malaria is common, please take your anti-malarial drugs. Do not skip it! It will save your life, truly truly save your life. Also, make sure you reduce the risks for malaria by getting rid of stagnant water pools, having screened doors and windows, and sleeping with a mosquito net if you must. Please, do not take this lightly.
Be well, be happy, and live!
Reference: Konotey-Ahulu FI D. Malaria and sickle cell: “Protection?” Or “No Protection?” – Confusion reigns. BMJ Rapid Response October 13 2008 http://bit.ly/2xgvOZO