Bundi, Caroline K; Nalwoga, Angela; Lubyayi, Lawrence; Muriuki, John Muthii; Mogire, Reagan M; Opi, Herbert; Mentzer, Alexander J; Mugyenyi, Cleopatra K; Mwacharo, Jedida; Webb, Emily L; +7 more... Bejon, Philip; Williams, Thomas N; Gikunju, Joseph K; Beeson, James G; Elliott, Alison M; Ndungu, Francis M; Atkinson, Sarah H; (2020) Iron deficiency is associated with reduced levels of Plasmodium falciparum-specific antibodies in African children. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. ISSN 1058-4838 DOI: https://doi.org/10.1093/cid/ciaa728
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Abstract
BACKGROUND: Iron deficiency (ID) and malaria are common causes of ill-health and disability among children living in sub-Saharan Africa. Although iron is critical for the acquisition of humoral immunity, little is known about the effects of ID on antibody responses to Plasmodium falciparum malaria. METHODS: The study included 1,794 Kenyan and Ugandan children aged 0-7 years. We measured biomarkers of iron and inflammation, and antibodies to P falciparum antigens including apical merozoite antigen 1 (anti-AMA-1) and merozoite surface antigen 1 (anti-MSP-1) in cross-sectional and longitudinal studies. RESULTS: The overall prevalence of ID was 31%. ID was associated with lower anti-AMA-1 and anti-MSP-1 antibody levels in pooled analyses adjusted for age, gender, study site, inflammation and P falciparum parasitemia (adjusted mean difference on a log-transformed scale (β) -0.46; 95 CI -0.66, -0.25 P <0.0001; β -0.33; 95 CI -0.50, -0.16 P <0.0001, respectively). Additional covariates for malaria exposure index, previous malaria episodes, and time since last malaria episode, were available for individual cohorts. Meta-analysis was used to allow for these adjustments giving β -0.34; -0.52, -0.16 for anti-AMA-1 antibodies and β -0.26; -0.41, -0.11 for anti-MSP-1 antibodies. Low transferrin saturation was similarly associated with reduced anti-AMA1 antibody levels. Lower AMA-1 and MSP-1 specific antibody levels persisted over time in iron-deficient children. CONCLUSIONS: Reduced levels of P. falciparum-specific antibodies in iron-deficient children might reflect impaired acquisition of immunity to malaria and/or reduced malaria exposure. Strategies to prevent and treat ID may influence antibody responses to malaria for children living in sub-Saharan Africa.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Research Centre | Malaria Centre |
PubMed ID | 32507899 |
Elements ID | 148238 |