Hemoglobin C and resistance to severe malaria in Ghanaian children.
Hemoglobin (Hb) C has been reported to protect against severe malaria. It is unclear whether relative resistance affects infection, disease, or both. Its extent may vary between regions and with disease pattern. We conducted a case-control study of children with severe malaria, asymptomatic parasitemic children, and healthy children in Ghana. HbAC did not prevent infection but reduced the odds of developing severe malaria and severe anemia. Protection was stronger with HbAS. The frequencies of HbCC and HbSC decreased, from healthy children to asymptomatic parasitemic children to children with severe malaria. These data support the notion that natural selection of HbC occurs because of the relative resistance it confers against severe malaria but argue against the notion that HbC offers resistance to infection.
Mockenhaupt
Frank P
FP
Institute of Tropical Medicine, Medical Faculty Charité, Humboldt University, Berlin, Germany. frank.mockenhaupt@charite.de
Ehrhardt
Stephan
S
Cramer
Jakob P
JP
Otchwemah
Rowland N
RN
Anemana
Sylvester D
SD
Goltz
Katharina
K
Mylius
Franziska
F
Dietz
Ekkehart
E
Eggelte
Teunis A
TA
Bienzle
Ulrich
U
D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006444:Hemoglobin C / Q000032:analysis / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate; D007223:Infant; D016778:Malaria, Falciparum / Q000235:genetics / Q000276:immunology* / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D010963:Plasmodium falciparum / Q000472:pathogenicity; D012720:Severity of Illness Index
D006444:Hemoglobin C