Iron Status and Associated Malaria Risk Among African Children.
Iron Status and Associated Malaria Risk Among African Children.
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DOI：
10.1093/cid/ciy791
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发表时间：
2019-05-17
期刊：
影响因子：
--
通讯作者：
Atkinson SH
中科院分区：
文献类型：
--
作者：
Muriuki JM;Mentzer AJ;Kimita W;Ndungu FM;Macharia AW;Webb EL;Lule SA;Morovat A;Hill AVS;Bejon P;Elliott AM;Williams TN;Atkinson SH
目前尚不清楚改善铁状况是否会增加疟疾风险，很少有研究关注宿主铁状况对随后疟疾感染的影响。因此，我们的目标是确定儿童的铁状况是否会影响他们随后在撒哈拉以南非洲感染疟疾的风险。我们分析了1309名肯尼亚和1374名乌干达0-7岁儿童的铁和炎症生物标志物，并对疟疾发作进行了前瞻性监测。Poisson回归模型拟合，以确定铁的状态对发病率比（IRR）的疟疾使用的纵向数据，涵盖了6个月的影响。根据年龄、性别、寄生虫血症、炎症和研究部位调整模型。在基线时，肯尼亚和乌干达儿童的铁缺乏症（ID）患病率分别为36.9%和34.6%。23.6%的肯尼亚儿童和17.6%的乌干达儿童患有ID贫血。患有ID（IRR，0.7; 95%置信区间[CI]，0.6，0.8; P < .001）和IDA（IRR，0.7; 95% CI，0.6，0.9; P = .006）的儿童的疟疾风险较低。低转铁蛋白饱和度（<10%）与较低的疟疾风险相似（IRR，0.8; 95%CI，0.6，0.9; P = 0.016）。然而，铁调素、可溶性转铁蛋白受体（sTfR）和血红蛋白/贫血的变化与疟疾风险的改变无关。当使用铁蛋白和转铁蛋白饱和度定义时，ID似乎可以保护非洲儿童免受疟疾感染，但当使用铁调素，sTfR或血红蛋白定义时则不然。需要进一步的研究来确定因果关系。ISRCTN 32849447铁蛋白和转铁蛋白饱和度降低与非洲儿童的疟疾保护有关。铁调素、可溶性转铁蛋白受体和血红蛋白浓度与疟疾保护无关。这些发现可能反映了寄生虫铁获取的差异。
It remains unclear whether improving iron status increases malaria risk, and few studies have looked at the effect of host iron status on subsequent malaria infection. We therefore aimed to determine whether a child’s iron status influences their subsequent risk of malaria infection in sub-Saharan Africa. We assayed iron and inflammatory biomarkers from community-based cohorts of 1309 Kenyan and 1374 Ugandan children aged 0–7 years and conducted prospective surveillance for episodes of malaria. Poisson regression models were fitted to determine the effect of iron status on the incidence rate ratio (IRR) of malaria using longitudinal data covering a period of 6 months. Models were adjusted for age, sex, parasitemia, inflammation, and study site. At baseline, the prevalence of iron deficiency (ID) was 36.9% and 34.6% in Kenyan and Ugandan children, respectively. ID anemia (IDA) affected 23.6% of Kenyan and 17.6% of Ugandan children. Malaria risk was lower in children with ID (IRR, 0.7; 95% confidence interval [CI], 0.6, 0.8; P < .001) and IDA (IRR, 0.7; 95% CI, 0.6, 0.9; P = .006). Low transferrin saturation (<10%) was similarly associated with lower malaria risk (IRR, 0.8; 95% CI, 0.6, 0.9; P = .016). However, variation in hepcidin, soluble transferrin receptors (sTfR), and hemoglobin/anemia was not associated with altered malaria risk. ID appears to protect against malaria infection in African children when defined using ferritin and transferrin saturation, but not when defined by hepcidin, sTfR, or hemoglobin. Additional research is required to determine causality. ISRCTN32849447 Decreased ferritin and transferrin saturation are associated with protection against malaria in African children. Hepcidin, soluble transferrin receptor, and hemoglobin concentrations are not associated with malaria protection. These findings may reflect differences in parasite iron acquisition.
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影响因子：
5.7
作者：
Iyer, JK;Shi, LR;Sullivan, DJ
通讯作者：
Sullivan, DJ
影响因子：
11.1
作者：
Goheen, M. M.;Wegmueller, R.;Bah, A.;Darboe, B.;Danso, E.;Affara, M.;Gardner, D.;Patel, J. C.;Prentice, A. M.;Cerami, C.
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6.4
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Lozoff, Betsy
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Elliott, Alison M.;Kizza, Moses;Whitworth, James A. G.
通讯作者：
Whitworth, James A. G.