Iron deficiency and malaria among children living on the coast of Kenya.
Both iron deficiency and malaria are common in much of sub-Saharan Africa, and the interaction between these conditions is complex. To investigate the association between nutritional iron status, immunoglobulins, and clinical Plasmodium falciparum malaria, we determined the incidence of malaria in a cohort of children between the ages of 8 months and 8 years who were living on the Kenyan coast. Biochemical iron status and malaria-specific immune responses were determined during 2 cross-sectional surveys. We found that the incidence of clinical malaria was significantly lower among iron-deficient children (incidence-rate ratio [IRR], 0.70; 95% confidence interval [CI], 0.51-0.99; P<.05), that the incidence of malaria was significantly associated with plasma ferritin concentration (IRR for log ferritin concentration, 1.48; 95% CI, 1.01-2.17; P<.05), and that iron status was strongly associated with a range of malaria-specific immunoglobulins. We conclude that iron deficiency was associated with protection from mild clinical malaria in our cohort of children in coastal Kenya and discuss possible mechanisms for this protection.
Nyakeriga
Alice M
AM
Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kenya. nyakeriga@imun.su.se
Troye-Blomberg
Marita
M
Dorfman
Jeffrey R
JR
Alexander
Neal D
ND
Bäck
Rune
R
Kortok
Moses
M
Chemtai
Alex K
AK
Marsh
Kevin
K
Williams
Thomas N
TN
D018798:Anemia, Iron-Deficiency / Q000150:complications* / Q000453:epidemiology*; D000818:Animals; D000918:Antibody Specificity; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005293:Ferritins / Q000097:blood; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D007223:Infant; D007501:Iron / Q000097:blood; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology*; D009752:Nutritional Status; D010963:Plasmodium falciparum / Q000276:immunology
D007074:Immunoglobulin G; D007073:Immunoglobulin E; D005293:Ferritins; D007501:Iron