Effect of α+-thalassaemia on episodes of fever due to malaria and other causes: a community-based cohort study in Tanzania
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- 作者：Jacobien Veenemans (1) (5)
Esther JS Jansen (1)
Amrish Y Baidjoe (1)
Erasto V Mbugi (2)
Ay?e Y Demir (3)
Rob J Kraaijenhagen (3)
Huub FJ Savelkoul (1)
Hans Verhoef (1) (4) - 刊名：Malaria Journal
- 出版年：2011
- 出版时间：December 2011
- 年：2011
- 卷：10
- 期：1
- 全文大小：407KB
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Esther JS Jansen (1)
Amrish Y Baidjoe (1)
Erasto V Mbugi (2)
Ay?e Y Demir (3)
Rob J Kraaijenhagen (3)
Huub FJ Savelkoul (1)
Hans Verhoef (1) (4)
1. Wageningen University, Cell Biology and Immunology Group, Wageningen, The Netherlands
5. Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands
2. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, Tanzania
3. Meander Medical Centre, Laboratory for Clinical Chemistry and Haematology, Amersfoort, The Netherlands
4. London School of Hygiene and Tropical Medicine, London, UK
文摘
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.