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  • Iron In Malaria

    From ironjustice@21:1/5 to All on Wed Sep 19 06:41:16 2018
    Iron Status and Associated Malaria Risk Among African Children.
    Muriuki JM1, Mentzer AJ2, Kimita W1, Ndungu FM1, Macharia AW1, Webb EL3, Lule SA4, Morovat A5, Hill AVS6, Bejon P1,7, Elliott AM3,4, Williams TN1,8, Atkinson SH1,7,9.
    Clin Infect Dis. 2018 Sep 14. doi: 10.1093/cid/ciy791.
    Abstract
    BACKGROUND:
    It remains unclear whether improving iron status increases malaria risk, and few studies have looked at the effect of host iron status on subsequent malaria infection. We therefore aimed to determine whether a child's iron status influences their
    subsequent risk of malaria infection in sub-Saharan Africa.

    METHODS:
    We assayed iron and inflammatory biomarkers from community-based cohorts of 1309 Kenyan and 1374 Ugandan children aged 0 - 7 years and conducted prospective surveillance for episodes of malaria. Poisson regression models were fitted to determine the
    effect of iron status on the incidence rate ratio of malaria using longitudinal data covering a period of 6 months. Models were adjusted for age, sex, parasitemia, inflammation and study site.

    RESULTS:
    At baseline, the prevalence of iron deficiency (ID) was 36.9% and 34.6% in Kenyan and Ugandan children, respectively. Iron deficiency anemia (IDA) affected 23.6% of Kenyan and 17.6% of Ugandan children. Malaria risk was lower in children with ID (IRR = 0.
    7; 95% CI: 0.6, 0.8; p<0.001) and IDA (IRR = 0.7; 95% CI: 0.6, 0.9; p=0.006). Low transferrin saturation (<10%) was similarly associated with lower malaria risk (IRR = 0.8; 95% CI: 0.6, 0.9; p=0.016). However, variation in hepcidin, soluble transferrin
    receptors (sTfR) and hemoglobin / anemia was not associated with altered malaria risk.

    CONCLUSIONS:
    ID appears to protect against malaria infection in African children when defined using ferritin and transferrin saturation, but not when defined by hepcidin, sTfR or hemoglobin. Further research is required to determine causality.

    PMID: 30219845 DOI: 10.1093/cid/ciy791

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