Open AccessMalaria is a cause of iron deficiency in African children
Author(s) -
John M. Muriuki,
Alexander J. Mentzer,
Ruth E. Mitchell,
Emily L. Webb,
Anthony Etyang,
Catherine Kyobutungi,
Alireza Morovat,
Wandia Kimita,
Francis M. Ndungu,
Alex Macharia,
Caroline Ngetsa,
Johnstone Makale,
Swaib A. Lule,
Solomon K. Musani,
Laura M. Raffield,
Clare Cutland,
Sodiomon B. Sirima,
Amidou Diarra,
Alfred B. Tiono,
Michal Fried,
M. Gwamaka,
Seth AduAfarwuah,
James P. Wirth,
Rita Wegmüller,
Shabir A. Madhi,
Robert W. Snow,
Adrian V. S. Hill,
Kirk A. Rockett,
Manjinder S. Sandhu,
Dominic Kwiatkowski,
Andrew M. Prentice,
Kendra Byrd,
Alex Ndjebayi,
Christine P. Stewart,
Reina EngleStone,
Tim Green,
Crystal D Karakochuk,
Parminder S. Suchdev,
Philip Bejon,
Patrick E. Duffy,
George Davey Smith,
Alison M. Elliott,
Thomas N. Williams,
Sarah H. Atkinson
Publication year - 2021
Publication title -
nature medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 19.536
H-Index - 547
eISSN - 1546-170X
pISSN - 1078-8956
DOI - 10.1038/s41591-021-01238-4
Subject(s) - malaria , sickle cell trait , mendelian randomization , medicine , observational study , environmental health , odds ratio , public health , incidence (geometry) , pediatrics , biology , immunology , disease , genotype , genetics , pathology , physics , gene , genetic variants , optics
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%.
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