title: Novel Insights Into the Protective Role of Hemoglobin S and C Against Plasmodium falciparum Parasitemia.
abstract: Although hemoglobin S (HbS) and hemoglobin C (HbC) are well known to protect against severe Plasmodium falciparum malaria, conclusive evidence on their role against infection has not yet been obtained. Here we show, in 2 populations from Burkina Faso (2007-2008), that HbS is associated with a 70% reduction of harboring P. falciparum parasitemia at the heterozygous state (odds ratio [OR] for AS vs AA, 0.27; 95% confidence interval [CI], .11-.66; P = .004). There is no evidence of protection for HbC in the heterozygous state (OR for AC vs AA, 1.49; 95% CI, .69-3.21; P = .31), whereas protection even higher than that observed with AS is observed in the homozygous and double heterozygous states (OR for CC + SC vs AA, 0.04; 95% CI, .01-.29; P = .002). The abnormal display of parasite-adhesive molecules on the surface of HbS and HbC infected erythrocytes, disrupting the pathogenic process of sequestration, might displace the parasite from the deep to the peripheral circulation, promoting its elimination at the spleen level.
authors.affiliation: Department of Public Health and Infectious Diseases Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza University of Rome, Italy.
authors.forename: Valentina D
authors.initials: VD
authors.lastname: Mangano
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Youssouf
authors.initials: Y
authors.lastname: Kabore
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Edith C
authors.initials: EC
authors.lastname: Bougouma
authors.affiliation: Department of Public Health and Infectious Diseases.
authors.forename: Federica
authors.initials: F
authors.lastname: Verra
authors.affiliation: London School of Hygiene and Tropical Medicine Center of Statistics and Applications of University of Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Sepulveda
authors.affiliation: Department of Public Health and Infectious Diseases Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Bisseye
authors.affiliation: Department of Public Health and Infectious Diseases.
authors.forename: Federica
authors.initials: F
authors.lastname: Santolamazza
authors.affiliation: Department of Public Health and Infectious Diseases.
authors.forename: Pamela
authors.initials: P
authors.lastname: Avellino
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Alfred B
authors.initials: AB
authors.lastname: Tiono
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Amidou
authors.initials: A
authors.lastname: Diarra
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Issa
authors.initials: I
authors.lastname: Nebie
authors.affiliation: Wellcome Trust Centre for Human Genetics, University of Oxford Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Rockett
authors.affiliation: Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
authors.forename: Sodiomon B
authors.initials: SB
authors.lastname: Sirima
authors.affiliation: Department of Public Health and Infectious Diseases Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza University of Rome, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Modiano
mesh_terms: D000293:Adolescent; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006444:Hemoglobin C; D006451:Hemoglobin, Sickle; D006579:Heterozygote; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D018512:Parasitemia; D010963:Plasmodium falciparum; D012307:Risk Factors; D012805:Sickle Cell Trait / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D055815:Young Adult
chemical_list: D006451:Hemoglobin, Sickle; D006444:Hemoglobin C
keywords: Burkina Faso; Fulani; Plasmodium falciparum; hemoglobin C; hemoglobin S; infection