Malaria is a cause of iron deficiency in African children.
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Alexander J
Mentzer
;
Ruth
Mitchell
;
Emily L
Webb
;
Anthony O
Etyang
;
Catherine
Kyobutungi
;
Alireza
Morovat
;
Wandia
Kimita
;
Francis M
Ndungu
;
Alex W
Macharia
;
+34 more...
Caroline J
Ngetsa
;
Johnstone
Makale
;
Swaib A
Lule
;
Solomon K
Musani
;
Laura M
Raffield
;
Clare L
Cutland
;
Sodiomon B
Sirima
;
Amidou
Diarra
;
Alfred B
Tiono
;
Michal
Fried
;
Moses
Gwamaka
;
Seth
Adu-Afarwuah
;
James P
Wirth
;
Rita
Wegmüller
;
Shabir A
Madhi
;
Robert W
Snow
;
Adrian VS
Hill
;
Kirk A
Rockett
;
Manjinder S
Sandhu
;
Dominic P
Kwiatkowski
;
Andrew M
Prentice
;
Kendra A
Byrd
;
Alex
Ndjebayi
;
Christine P
Stewart
;
Reina
Engle-Stone
;
Tim J
Green
;
Crystal D
Karakochuk
;
Parminder S
Suchdev
;
Philip
Bejon
;
Patrick E
Duffy
;
George
Davey Smith
;
Alison M
Elliott
;
Thomas N
Williams
;
Sarah H
Atkinson
;
(2021)
Malaria is a cause of iron deficiency in African children.
Nature medicine, 27 (4).
pp. 653-658.
ISSN 1078-8956
DOI: 10.1038/s41591-021-01238-4
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 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%.
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subject - Published Version
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