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Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania
BACKGROUND: It is controversial to what degree α(+)-thalassaemia protects against episodes of uncomplicated malaria and febrile disease due to infections other than Plasmodium. METHODS: In Tanzania, in children aged 6-60 months and height-for-age z-score < -1.5 SD (n = 612), rates of fevers due t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195205/ https://www.ncbi.nlm.nih.gov/pubmed/21939508 http://dx.doi.org/10.1186/1475-2875-10-280 |
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author | Veenemans, Jacobien Jansen, Esther JS Baidjoe, Amrish Y Mbugi, Erasto V Demir, Ayşe Y Kraaijenhagen, Rob J Savelkoul, Huub FJ Verhoef, Hans |
author_facet | Veenemans, Jacobien Jansen, Esther JS Baidjoe, Amrish Y Mbugi, Erasto V Demir, Ayşe Y Kraaijenhagen, Rob J Savelkoul, Huub FJ Verhoef, Hans |
author_sort | Veenemans, Jacobien |
collection | PubMed |
description | BACKGROUND: It is controversial to what degree α(+)-thalassaemia protects against episodes of uncomplicated malaria and febrile disease due to infections other than Plasmodium. METHODS: In 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. RESULTS: The 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. CONCLUSIONS: In 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. |
format | Online Article Text |
id | pubmed-3195205 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31952052011-10-18 Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania Veenemans, Jacobien Jansen, Esther JS Baidjoe, Amrish Y Mbugi, Erasto V Demir, Ayşe Y Kraaijenhagen, Rob J Savelkoul, Huub FJ Verhoef, Hans Malar J Review BACKGROUND: It is controversial to what degree α(+)-thalassaemia protects against episodes of uncomplicated malaria and febrile disease due to infections other than Plasmodium. METHODS: In 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. RESULTS: The 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. CONCLUSIONS: In 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. BioMed Central 2011-09-22 /pmc/articles/PMC3195205/ /pubmed/21939508 http://dx.doi.org/10.1186/1475-2875-10-280 Text en Copyright ©2011 Veenemans et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 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. |
spellingShingle | Review Veenemans, Jacobien Jansen, Esther JS Baidjoe, Amrish Y Mbugi, Erasto V Demir, Ayşe Y Kraaijenhagen, Rob J Savelkoul, Huub FJ Verhoef, Hans Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title | Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title_full | Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title_fullStr | Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title_full_unstemmed | Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title_short | Effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania |
title_sort | effect of α(+)-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in tanzania |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195205/ https://www.ncbi.nlm.nih.gov/pubmed/21939508 http://dx.doi.org/10.1186/1475-2875-10-280 |
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