학술논문
Malaria is a cause of iron deficiency in African children
Document Type
article
Author
Muriuki, John Muthii; Mentzer, Alexander J; Mitchell, Ruth; Webb, Emily L; Etyang, Anthony O; Kyobutungi, Catherine; Morovat, Alireza; Kimita, Wandia; Ndungu, Francis M; Macharia, Alex W; Ngetsa, Caroline J; Makale, Johnstone; Lule, Swaib A; Musani, Solomon K; Raffield, Laura M; Cutland, Clare L; Sirima, Sodiomon B; Diarra, Amidou; Tiono, Alfred B; Fried, Michal; Gwamaka, Moses; Adu-Afarwuah, Seth; Wirth, James P; Wegmüller, Rita; Madhi, Shabir A; Snow, Robert W; Hill, Adrian VS; Rockett, Kirk A; Sandhu, Manjinder S; Kwiatkowski, Dominic P; Prentice, Andrew M; Byrd, Kendra A; Ndjebayi, Alex; Stewart, Christine P; Engle-Stone, Reina; Green, Tim J; Karakochuk, Crystal D; Suchdev, Parminder S; Bejon, Philip; Duffy, Patrick E; Davey Smith, George; Elliott, Alison M; Williams, Thomas N; Atkinson, Sarah H
Source
Nature Medicine. 27(4)
Subject
Language
Abstract
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 ID1. To test the hypothesis that malaria might cause ID, we used sickle cell trait (HbAS, rs334 ), a genetic variant that confers specific protection against malaria2, 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%.