title: Protective effects of the sickle cell gene against malaria morbidity and mortality.
abstract: The high frequency of the sickle-cell haemoglobin (HbS) gene in malaria endemic regions is believed to be due to a heterozygote (HbAS) advantage against fatal malaria. Data to prospectively confirm the protection associated with HbAS against mortality are lacking. We show that HbAS provides significant protection against all-cause mortality, severe malarial anaemia, and high-density parasitaemia. This significant reduction in mortality was detected between the ages of 2 and 16 months, the highest risk period for severe malarial anaemia in this area. These data are important in understanding the role of malaria in the selection and maintenance of the sickle cell gene.
authors.forename: Michael
authors.initials: M
authors.lastname: Aidoo
authors.forename: Dianne J
authors.initials: DJ
authors.lastname: Terlouw
authors.forename: Margarette S
authors.initials: MS
authors.lastname: Kolczak
authors.forename: Peter D
authors.initials: PD
authors.lastname: McElroy
authors.forename: Feiko O
authors.initials: FO
authors.lastname: ter Kuile
authors.forename: Simon
authors.initials: S
authors.lastname: Kariuki
authors.forename: Bernard L
authors.initials: BL
authors.lastname: Nahlen
authors.forename: Altaf A
authors.initials: AA
authors.lastname: Lal
authors.forename: Venkatachalam
authors.initials: V
authors.lastname: Udhayakumar
mesh_terms: D015331:Cohort Studies; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control; D016012:Poisson Distribution; D012805:Sickle Cell Trait / Q000235:genetics*