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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.

Veenemans, J., Jansen, E. J. S., Baidjoe, A. Y., Mbugi, E. V., Demir, A. Y., Kraaijenhagen, R. J., Savelkoul, H. F. J. and Verhoef, H. (2011) Effect of α(+)-Thalassaemia on Episodes of Fever due to Malaria and Other Causes: A Community-Based Cohort Study in Tanzania. Malaria journal, 10. p. 280. ISSN 1475-2875

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It is controversial to what degree α(+)-thalassaemia protects against episodes of uncomplicated malaria and febrile disease due to infections other than Plasmodium. 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. 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. 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.

Item Type: Article
Keywords: Thalassaemia, Malaria,febrile disease,Plasmodium, heterozygous or homozygotes,Cox regression models,genotypes
Subjects: ?? HS10 ??
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Divisions: ?? muhas ??
Depositing User: Users 61 not found.
Date Deposited: 05 Jun 2013 07:30
Last Modified: 05 Jun 2013 07:30

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