Iron deficiency may protect against malaria infection in children
Iron deficiency is associated with a reduced risk of developing malaria infection, as shown in a cohort study of African children. As such, improving iron status may predispose this population to infection.
Researchers examined iron and inflammatory biomarkers in community-based cohorts of 1,309 Kenyan and 1,374 Ugandan children. Mean age of the entire population was 2.3 years, and about 51 percent were boys.
At baseline, the respective prevalence rates of iron deficiency and iron-deficiency anaemia (IDA) were 36.9 percent and 23.6 percent in the Kenyan cohort and 34.6 percent and 17.6 percent in the Ugandan cohort. Meanwhile the prevalence of malaria parasitemia was higher in the Kenyan vs Ugandan cohort (20.1 percent vs 6.7 percent).
At least one episode of malaria infection occurred in 31.1 percent of Kenyan children and 14.3 percent of Ugandan children over the 6-month follow-up.
Poisson regression models showed that the risk of malaria was lower in children with iron deficiency (incidence rate ratio [IRR], 0.7; 95 percent CI, 0.6–0.8; p<0.001) and IDA (IRR, 0.7; 0.6–0.9; p=0.006). Likewise, low transferrin saturation (<10 percent) was associated with reduced malaria risk (IRR, 0.8; 0.6–0.9; p=0.016).
Factors such as variation in hepcidin, soluble transferrin receptors (sTfR) and haemoglobin/anaemia were not associated with the risk.
Researchers highlighted the need for large-scale prospective interventional trials, as well as studies that utilize genetic variants associated with iron status in order to infer causality (Mendelian randomization). It is especially important to establish causality in the iron-malaria relationship because iron deficiency prevents children from reaching their developmental potential.