Journal Article

Malaria is a cause of iron deficiency in African children

Rockett, Kirk A., Duffy, Patrick E., Ngetsa, Caroline J., Sirima, Sodiomon B., Wirth, James P., Diarra, Amidou, Wegmüller, Rita, Fried, Michal, Davey Smith, George, Morovat, Alireza, Lule, Swaib A., Raffield, Laura M., Karakochuk, Crystal D., Muriuki, John Muthii, Cutland, Clare L., Madhi, Shabir A., Kyobutungi, Catherine, Macharia, Alex W., Adu-Afarwuah, Seth, Sandhu, Manjinder S., Williams, Thomas N., Atkinson, Sarah H., Bejon, Philip, Ndungu, Francis M., Musani, Solomon K., Snow, Robert W., Gwamaka, Moses, Suchdev, Parminder S., Mitchell, Ruth, Kimita, Wandia, Makale, Johnstone, Webb, Emily L., Elliott, Alison M., Hill, Adrian V. S., Engle-Stone, Reina, Tiono, Alfred B., Kwiatkowski, Dominic P., Prentice, Andrew M., Mentzer, Alexander J., Ndjebayi, Alex, Byrd, Kendra A., Green, Tim J., Etyang, Anthony O., Stewart, Christine P.

2021

Overview

Malaria and iron deficiency (ID) are common and interrelated public health problems in African children. Observational data suggest that interrupting malaria transmission reduces the prevalence of ID 1 . To test the hypothesis that malaria might cause ID, we used sickle cell trait (HbAS, rs334 ), a genetic variant that confers specific protection against malaria 2 , as an instrumental variable in Mendelian randomization analyses. HbAS was associated with a 30% reduction in ID among children living in malaria-endemic countries in Africa ( n  = 7,453), but not among individuals living in malaria-free areas ( n  = 3,818). Genetically predicted malaria risk was associated with an odds ratio of 2.65 for ID per unit increase in the log incidence rate of malaria. This suggests that an intervention that halves the risk of malaria episodes would reduce the prevalence of ID in African children by 49%. A genetic link suggests that interventions that halve the risk of malaria episodes could reduce the prevalence of iron deficiency in African children by nearly 50%.

• Publisher: Nature Publishing Group US,Nature Publishing Group
• Subject: 631/208/1516 / 692/308/174 / 692/308/2056 / 692/699/1702 / 706/134 / Absorption, Physiological / Adolescent / Africa / Biomedical and Life Sciences / Biomedicine / Cancer Research / Causes of / Child / Child, Preschool / Children / Complications and side effects / Disease transmission / Female / Genetic aspects / Genetic diversity / Genetic variance / Genetic variation / Geography / Health problems / Health risks / Hepcidins - metabolism / Humans / Infant / Infectious Diseases / Iron / Iron Deficiencies / Iron deficiency / Iron deficiency diseases / Letter / Malaria / Malaria - complications / Male / Mendelian Randomization Analysis / Metabolic Diseases / Molecular Medicine / Neurosciences / Nutrient deficiency / Pediatric research / Public health / Risk / Risk factors / Sickle Cell Trait - complications / Statistics / Vector-borne diseases