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Malaria is a cause of iron deficiency in African children.


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%.

SUBMITTER: Muriuki JM 

PROVIDER: S-EPMC7610676 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Malaria is a cause of iron deficiency in African children.

Muriuki John Muthii JM   Mentzer Alexander J AJ   Mitchell Ruth R   Webb Emily L EL   Etyang Anthony O AO   Kyobutungi Catherine C   Morovat Alireza A   Kimita Wandia W   Ndungu Francis M FM   Macharia Alex W AW   Ngetsa Caroline J CJ   Makale Johnstone J   Lule Swaib A SA   Musani Solomon K SK   Raffield Laura M LM   Cutland Clare L CL   Sirima Sodiomon B SB   Diarra Amidou A   Tiono Alfred B AB   Fried Michal M   Gwamaka Moses M   Adu-Afarwuah Seth S   Wirth James P JP   Wegmüller Rita R   Madhi Shabir A SA   Snow Robert W RW   Hill Adrian V S AVS   Rockett Kirk A KA   Sandhu Manjinder S MS   Kwiatkowski Dominic P DP   Prentice Andrew M AM   Byrd Kendra A KA   Ndjebayi Alex A   Stewart Christine P CP   Engle-Stone Reina R   Green Tim J TJ   Karakochuk Crystal D CD   Suchdev Parminder S PS   Bejon Philip P   Duffy Patrick E PE   Davey Smith George G   Elliott Alison M AM   Williams Thomas N TN   Atkinson Sarah H SH  

Nature medicine 20210222 4


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<sup>1</sup>. 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<sup>2</sup>, as an instrumental variable in Mendelian randomization analyses. HbAS was associated with a 30% reduction in ID a  ...[more]

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