title: Effects of inflammation and Plasmodium falciparum infection on soluble transferrin receptor and plasma ferritin concentration in different age groups: a prospective longitudinal study in Côte d'Ivoire.
abstract: BACKGROUND
  Iron deficiency (ID) is a major cause of anemia, along with other nutritional, parasitic, and genetic factors. Accurate biomarkers are needed to estimate the relative contribution of ID to anemia. Soluble transferrin receptor (sTfR) is thought to be unaffected by inflammation.
  
  
  OBJECTIVE
  The objectives were to determine the difference in sTfR and plasma ferritin (PF) concentrations among infants (6-23 mo of age), school-age children (6-8 y of age), and women (15-25 y of age) with and without inflammation and with and without Plasmodium falciparum infection and to assess the effect of adjusting sTfR and PF for inflammation or for P. falciparum infection on the estimated prevalence of ID.
  
  
  METHODS
  The data were derived from a 14-mo prospective longitudinal survey on anemia, which was conducted in the Taabo area, south-central Côte d'Ivoire.
  
  
  RESULTS
  At baseline, sTfR concentration was significantly higher in infants and school-age children with either inflammation or P. falciparum infection than in control individuals without inflammation or without P. falciparum infection. Individuals with inflammation had significantly higher PF concentrations than did subjects without inflammation. Adjustments in sTfR concentrations for inflammation or P. falciparum infection in infants and school-age children resulted in significantly lower ID prevalence. Adjustment of PF for inflammation and Plasmodium infection resulted in a higher ID prevalence in infants and women.
  
  
  CONCLUSIONS
  In Ivorian infants and school-age children, ID prevalence was considerably lower after adjustment of sTfR for inflammation. However, as the prevalence estimates for ID differed widely if based on sTfR or PF, caution is still needed when estimating ID prevalence in areas with a high prevalence of inflammation or malaria. This trial was registered at controlled-trials.com as ISRCTN02181959.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Aurélie A
authors.initials: AA
authors.lastname: Righetti
authors.forename: Rita
authors.initials: R
authors.lastname: Wegmüller
authors.forename: Dominik
authors.initials: D
authors.lastname: Glinz
authors.forename: Mamadou
authors.initials: M
authors.lastname: Ouattara
authors.forename: Lukas G
authors.initials: LG
authors.lastname: Adiossan
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'Goran
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hurrell
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002648:Child; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood* / Q000172:deficiency; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000150:complications / Q000453:epidemiology*; D008137:Longitudinal Studies; D008288:Malaria / Q000150:complications / Q000453:epidemiology*; D008297:Male; D010963:Plasmodium falciparum; D015995:Prevalence; D011446:Prospective Studies; D011990:Receptors, Transferrin / Q000097:blood* / Q000172:deficiency; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011990:Receptors, Transferrin; D005293:Ferritins