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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Iron deficiency protects against severe plasmodium falciparum malaria and death in young children
Clinical Infectious Diseases, Volume 54, No. 8, Year 2012
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Description
Background. Iron supplementation may increase malaria morbidity and mortality, but the effect of naturally occurring variation in iron status on malaria risk is not well studied.Methods.A total of 785 Tanzanian children living in an area of intense malaria transmission were enrolled at birth, and intensively monitored for parasitemia and illness including malaria for up to 3 years, with an average of 47 blood smears. We assayed plasma samples collected at routine healthy-child visits, and evaluated the impact of iron deficiency (ID) on future malaria outcomes and mortality. Results. ID at routine, well-child visits significantly decreased the odds of subsequent parasitemia (23% decrease, P <. 001) and subsequent severe malaria (38% decrease, P =. 04). ID was also associated with 60% lower all-cause mortality (P =. 04) and 66% lower malaria-associated mortality (P =. 11). When sick visits as well as routine healthy-child visits are included in analyses (average of 3 iron status assays/child), ID reduced the prevalence of parasitemia (6.6-fold), hyperparasitemia (24.0-fold), and severe malaria (4.0-fold) at the time of sample collection (all P <. 001).Conclusions.Malaria risk is influenced by physiologic iron status, and therefore iron supplementation may have adverse effects even among children with ID. Future interventional studies should assess whether treatment for ID coupled with effective malaria control can mitigate the risks of iron supplementation for children in areas of malaria transmission. © 2012 The Author.
Authors & Co-Authors
Gwamaka, Moses
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
Tanzania, Morogoro
Sokoine University of Agriculture
Kurtis, Jonathan D.
United States, Providence
Rhode Island Hospital
United States, Providence
The Warren Alpert Medical School
Sorensen, Bess
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
Holte, Sarah E.
United States, Seattle
Fred Hutchinson Cancer Research Center
Morrison, Robert D.
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
Mutabingwa, Theonest K.
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
Tanzania, Tanga
National Institute for Medical Research Tanga
Fried, Michal W.
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
United States, Seattle
University of Washington
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Duffy, Patrick Emmet
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Region
Muheza Designated District Hospital
United States, Seattle
University of Washington
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Statistics
Citations: 190
Authors: 8
Affiliations: 9
Identifiers
Doi:
10.1093/cid/cis010
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study