Hemoglobin C Trait Provides Protection From Clinical Falciparum Malaria in Malian Children

Background. Hemoglobin C trait, like hemoglobin S trait, protects against severe malaria in children, but it is unclear whether hemoglobin C trait also protects against uncomplicated malaria. We hypothesized that Malian children with hemoglobin C trait would have a lower risk of Glinical malaria tha...

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Bibliographic Details
Published in:The Journal of infectious diseases 2015-12, Vol.212 (11), p.1778-1786
Main Authors: Travassos, Mark A., Coulibaly, Drissa, Laurens, Matthew B., Dembélé, Ahmadou, Tolo, Youssouf, Koné, Abdoulaye K., Traoré, Karim, Niangaly, Amadou, Guindo, Aldiouma, Wu, Yukun, Berry, Andrea A., Jacob, Christopher G., Takala-Harrison, Shannon, Adams, Matthew, Shrestha, Biraj, Mu, Amy Z., Kouriba, Bourema, Lyke, Kirsten E., Diallo, Dapa A., Doumbo, Ogobara K., Plowe, Christopher V., Thera, Mahamadou A.
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Cohort Studies
Female
Genetic Predisposition to Disease - epidemiology
Genetic Predisposition to Disease - genetics
Hemoglobin C - genetics
Hemoglobin, Sickle - genetics
Humans
Incidence
Infant
Infant, Newborn
Major and Brief Reports
Malaria, Falciparum - epidemiology
Malaria, Falciparum - genetics
Male
Mali - epidemiology
PARASITES
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Summary:Background. Hemoglobin C trait, like hemoglobin S trait, protects against severe malaria in children, but it is unclear whether hemoglobin C trait also protects against uncomplicated malaria. We hypothesized that Malian children with hemoglobin C trait would have a lower risk of Glinical malaria than children with hemoglobin AA. Methods. Three hundred children aged 0-6 years were enrolled in a cohort study of malaria incidence in Bandiagara, Mali, with continuous passive and monthly active follow-up from June 2009 to June 2010. Results. Compared to hemoglobin AA children (n = 242), hemoglobin AC children (n = 39) had a longer time to first clinical malaria episode (hazard ratio [HR], 0.19; P = .001; 364 median malaria-free days vs 181 days), fewer episodes of clinical malaria, and a lower cumulative parasite burden. Similarly, hemoglobin AS children (n = 14) had a longer time to first clinical malaria episode than hemoglobin AA children (HR, 0.15; P= .015; 364 median malaria-free days vs 181 days), but experienced the most asymptomatic malaria infections of any group. Conclusions. Both hemoglobin and S traits exerted a protective effect against clinical malaria episodes, but appeared to do so by mechanisms that differentially affect the response to infecting malaria parasites.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiv308