title: Reduced risk of uncomplicated malaria episodes in children with alpha+-thalassemia in northeastern Tanzania.
abstract: The prevalence of human red blood cell (RBC) polymorphisms is high in areas of intense Plasmodium falciparum transmission, and individuals carrying these genetic traits are believed to be partially protected against severe malaria. However, it remains uncertain how RBC polymorphisms affect the susceptibility to uncomplicated malaria. We compared the risk of suffering from febrile, uncomplicated malaria between individuals carrying three common RBC polymorphisms (sickle cell trait, alpha(+)-thalassemia, and glucose-6-phosphate-dehydrogenase deficiency) and controls. The study was performed in an area of intense malaria transmission where 202 individuals 0-19 years of age were monitored clinically for a period of 6 months. RBC polymorphisms were assessed with molecular methods, and plasma antibodies to P. falciparum variant surface antigens (anti-VSA IgG) and glutamate-rich protein (anti-GLURP IgG) were measured with flow cytometry and ELISA assays, respectively. Regression analyses showed that alpha(+)-thalassemia was associated with a reduced risk of uncomplicated malaria episodes and that this advantageous effect seemed to be more predominant in children older than 5 years of age, but was independent of levels of antibodies to VSA and GLURP.
authors.affiliation: Centre for Medical Parasitology, Institute for International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark. enevold@cmp.dk
authors.forename: Anders
authors.initials: A
authors.lastname: Enevold
authors.forename: John P
authors.initials: JP
authors.lastname: Lusingu
authors.forename: Bruno
authors.initials: B
authors.lastname: Mmbando
authors.forename: Michael
authors.initials: M
authors.lastname: Alifrangis
authors.forename: Martha M
authors.initials: MM
authors.lastname: Lemnge
authors.forename: Ib C
authors.initials: IC
authors.lastname: Bygbjerg
authors.forename: Thor G
authors.initials: TG
authors.lastname: Theander
authors.forename: Lasse S
authors.initials: LS
authors.lastname: Vestergaard
mesh_terms: D000740:Anemia / Q000453:epidemiology / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D004247:DNA / Q000097:blood / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000235:genetics; D006454:Hemoglobins / Q000235:genetics; D006720:Homozygote; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D008297:Male; D020641:Polymorphism, Single Nucleotide; D012805:Sickle Cell Trait / Q000235:genetics; D013636:Tanzania / Q000453:epidemiology; D017085:alpha-Thalassemia / Q000150:complications / Q000453:epidemiology* / Q000235:genetics
chemical_list: D006454:Hemoglobins; D004247:DNA