Sickle cell trait and the risk of Plasmodium falciparum malaria and other childhood diseases
Sickle cell trait and the risk of Plasmodium falciparum malaria and other childhood diseases
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DOI：
10.1086/430744
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发表时间：
2005-07-01
影响因子：
6.4
通讯作者：
Marsh, K
中科院分区：
文献类型：
--
作者：
Williams, TN;Mwangi, TW;Marsh, K
背景。镰状血红蛋白 (HbS) 基因是自然选择的一个典型例子。人们普遍认为，目前在许多热带人群中的流行反映了通过对抗疟疾死亡的生存优势对携带者形式（镰状细胞性状 [HbAS]）的选择。然而，在这一假设首次提出 150 年后，HbAS、疟疾和其他儿童死亡常见原因之间关系的流行病学描述仍然不完整。方法。我们研究了居住在肯尼亚海岸的两组儿童的恶性疟疾和其他儿童疾病的发病率。结果。 HbAS 对恶性疟疾的保护作用非常特异，对任何其他疾病没有显着影响。 HbAS 对无症状寄生虫血症的患病率没有影响，但对轻度临床疟疾有 50% 的保护作用，对因疟疾入院有 75% 的保护作用，对严重或复杂疟疾有近 90% 的保护作用。 HbAS 对临床疟疾发作的影响反映在其对此类发作期间寄生虫密度的影响。结论。目前的数据非常有用，因为它们证实了 HbAS 提供预防疟疾的机制，并揭示了 HbAS、疟疾和其他儿童疾病之间的关系。
Background. The gene for sickle hemoglobin (HbS) is a prime example of natural selection. It is generally believed that its current prevalence in many tropical populations reflects selection for the carrier form (sickle cell trait [HbAS]) through a survival advantage against death from malaria. Nevertheless, 150 years after this hypothesis was first proposed, the epidemiological description of the relationships between HbAS, malaria, and other common causes of child mortality remains incomplete.Methods. We studied the incidence of falciparum malaria and other childhood diseases in 2 cohorts of children living on the coast of Kenya.Results. The protective effect of HbAS was remarkably specific for falciparum malaria, having no significant impact on any other disease. HbAS had no effect on the prevalence of symptomless parasitemia but was 50% protective against mild clinical malaria, 75% protective against admission to the hospital for malaria, and almost 90% protective against severe or complicated malaria. The effect of HbAS on episodes of clinical malaria was mirrored in its effect on parasite densities during such episodes.Conclusions. The present data are useful in that they confirm the mechanisms by which HbAS confers protection against malaria and shed light on the relationships between HbAS, malaria, and other childhood diseases.