Malaria is a cause of iron deficiency in African children

john muriuki*, Alexander J Mentzer, Ruth E Mitchell, Emily L Webb, Anthony O Etyang, Catherine Kyobutungi, Alireza Morovat, Wandia Kimita, Francis M Ndungu, Alex W Macharia, Caroline Ngetsa, Johnstone Makale, Swaib A Lule, Solomon K. Musani, Laura M Raffield, Clare L Cutland, Sodiomon B Sirima, Amidou Diarra, Alfred B Tiono, Michal FriedMoses Gwamaka, Seth Adu-Afarwuah, George Davey Smith

*Corresponding author for this work

Research output: Contribution to journalLetter (Academic Journal)peer-review

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%.
Original languageEnglish
Pages (from-to)653-658
Number of pages19
JournalNature Medicine
Volume27
Issue number4
DOIs
Publication statusPublished - 22 Feb 2021

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