Malaria is a cause of iron deficiency in African children

Nat Med. 2021 Apr;27(4):653-658. doi: 10.1038/s41591-021-01238-4. Epub 2021 Feb 22.

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%.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Absorption, Physiological
  • Adolescent
  • Africa
  • Child
  • Child, Preschool
  • Female
  • Geography
  • Hepcidins / metabolism
  • Humans
  • Infant
  • Iron Deficiencies*
  • Malaria / complications*
  • Male
  • Mendelian Randomization Analysis
  • Sickle Cell Trait / complications

Substances

  • Hepcidins

Grants and funding