Effect of α+-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania

Malaria Journal

Review

Amrish Y Baidjoe¹  Esther JS Jansen¹  Huub FJ Savelkoul¹  Jacobien Veenemans²  Hans Verhoef³  Ayşe Y Demir⁴  Rob J Kraaijenhagen⁴  Erasto V Mbugi⁵ 

[1] Cell Biology and Immunology Group, Wageningen University, Wageningen, The Netherlands;Cell Biology and Immunology Group, Wageningen University, Wageningen, The Netherlands;Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands;Cell Biology and Immunology Group, Wageningen University, Wageningen, The Netherlands;London School of Hygiene and Tropical Medicine, London, UK;Meander Medical Centre, Laboratory for Clinical Chemistry and Haematology, Amersfoort, The Netherlands;Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, Tanzania;

关键词: Malaria;    Haemoglobin Concentration;    Severe Malaria;    Parasite Density;    Uncomplicated Malaria;   

DOI  :  10.1186/1475-2875-10-280

 received in 2011-04-16, accepted in 2011-09-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundIt is controversial to what degree α+-thalassaemia protects against episodes of uncomplicated malaria and febrile disease due to infections other than Plasmodium.MethodsIn Tanzania, in children aged 6-60 months and height-for-age z-score < -1.5 SD (n = 612), rates of fevers due to malaria and other causes were compared between those with heterozygous or homozygotes α+-thalassaemia and those with a normal genotype, using Cox regression models that accounted for multiple events per child.ResultsThe overall incidence of malaria was 3.0/child-year (1, 572/526 child-years); no differences were found in malaria rates between genotypes (hazard ratios, 95% CI: 0.93, 0.82-1.06 and 0.91, 0.73-1.14 for heterozygotes and homozygotes respectively, adjusted for baseline factors that were predictive for outcome). However, this association strongly depended on age: among children aged 6-17 months, those with α+-thalassaemia experienced episodes more frequently than those with a normal genotype (1.30, 1.02-1.65 and 1.15, 0.80-1.65 for heterozygotes and homozygotes respectively), whereas among their peers aged 18-60 months, α+-thalassaemia protected against malaria (0.80, 0.68-0.95 and 0.78, 0.60-1.03; p-value for interaction 0.001 and 0.10 for hetero- and homozygotes respectively). No effect was observed on non-malarial febrile episodes.ConclusionsIn this population, the association between α+-thalassaemia and malaria depends on age. Our data suggest that protection by α+-thalassaemia is conferred by more efficient acquisition of malaria-specific immunity.

【 授权许可】

Unknown   
© Veenemans et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.