4.8 Article

Malaria is a cause of iron deficiency in African children

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NATURE MEDICINE
卷 27, 期 4, 页码 -

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NATURE PORTFOLIO
DOI: 10.1038/s41591-021-01238-4

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资金

  1. Wellcome [107769]
  2. Wellcome Centre for Human Genetics [090532, 203141]
  3. Wellcome Sanger Institute [098051, 206194]
  4. Oxford University Clinical Academic School Transitional Fellowship - Wellcome Trust Principal Fellowship [103602, 212176]
  5. DELTAS Africa Initiative [DEL-15-003]
  6. African Academy of Sciences' Alliance for Accelerating Excellence in Science in Africa
  7. New Partnership for Africa's Development Planning and Coordinating (NEPAD) Agency
  8. UK government
  9. MRC IEU [MC_UU_00011/1]
  10. UNICEF
  11. Canada's Ministry of Foreign Affairs, Trade and Development [43210308]
  12. Irish Aid
  13. World Bank
  14. Centers for Disease Control and Prevention and Emory University
  15. Thrasher Research Fund [12144, T32 HL129982]
  16. Bill & Melinda Gates Foundation [OPPGD759]
  17. US Agency for International Development [AID-OAA-F-13-00040]
  18. National Institutes of Health Research Training [R25 TW009343]
  19. Fogarty International Center
  20. University of California Global Health Institute
  21. National Institute of Allergy and Infectious Diseases (NIAID)
  22. National Institutes of Health [AI52059]
  23. Intramural Research Program of the NIAID
  24. Sight
  25. UK MRC [U1232661351, U105960371, MC-A760-5QX00]
  26. DFID under the MRC/DFID Concordat [HHSN268201800013I]
  27. Tougaloo College [HHSN268201800014I]
  28. Mississippi State Department of Health [HHSN268201800015I]
  29. University of Mississippi Medical Center [HHSN268201800010I, HHSN268201800011I, HHSN268201800012I]
  30. National Heart, Lung, and Blood Institute (NHLBI)
  31. National Institute on Minority Health and Health Disparities
  32. NHLBI [HHSN268201100037C, 3R01HL-117626-02S1, HHSN268201800002I, 3R01HL-120393-02S1, HHSN268201800001I]
  33. MRC [MC_UU_00027/5, MR/M006212/1, MC_U123292699, MC_UU_00026/3, MC_UU_00011/1, MC_UP_1204/15, MC_PC_MR/R020183/1] Funding Source: UKRI

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The study found a significant association between genetically predicted malaria risk and the prevalence of iron deficiency in African children, with a potential 49% reduction in ID if malaria episodes are halved as an intervention. Using HbAS as an instrumental variable in Mendelian randomization analyses, a 30% reduction in ID risk was observed in children living in malaria-endemic areas.
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 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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