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. 2022 Oct 1;21(1):278.
doi: 10.1186/s12936-022-04297-1.

Implication of asymptomatic and clinical Plasmodium falciparum infections on biomarkers of iron status among school-aged children in Malawi

Peter A M Ntenda  1 , Angeziwa C Chirambo  2 , Owen Nkoka  3 , Walaa M El-Meidany  4 , Jessy Goupeyou-Youmsi  5
Affiliations

Implication of asymptomatic and clinical Plasmodium falciparum infections on biomarkers of iron status among school-aged children in Malawi

Peter A M Ntenda et al. Malar J. .

Abstract

Background: Iron status is considered as a continuum from an iron deficiency with anaemia, without anaemia, varying amounts of stored iron to iron overload. The burden of Plasmodium falciparum infections is typically high among school-aged children (SAC). Nonetheless, SAC are often less likely to be covered by malaria interventions, making them a group with an untreated reservoir of parasite transmission. This study aimed to assess the effects of asymptomatic and clinical malaria infections on biochemical markers of iron status among SAC in Malawi.

Methods: Data from the 2015-2016 Malawi Micronutrient Survey (MNS) was used and multivariable logistic regression models using a generalized estimating equation to account for the complex cluster survey design were constructed. Blood samples of 684 children aged 5 to 14 years old were evaluated for clinical and asymptomatic malaria infections. Furthermore, blood samples were used to estimate haemoglobin (Hb), serum ferritin (SF) and, soluble transferrin receptors (sTfR) concentrations.

Results: Of the 684 SAC analysed, approximately 42% had asymptomatic malaria, while 41.0% had clinical malaria. Anaemia (low Hb levels), iron deficiency (low SF concentration), and functional iron deficiency (high sTfR levels) were found in 20%, 5%, and 30% of the children, respectively. School-aged children with asymptomatic malaria had increased odds of being anaemic (adjusted odds ratio [aOR]: 3.71, 95% confidence interval [CI]: 2.29-5.99) and increased levels of sTfR (aOR: 3.00, 95% CI 2.01-4.47). Similarly, SAC with clinical malaria had increased odds of being anaemic (aOR: 3.54, 95% CI 2.19-5.72) and increased levels of sTfR (aOR: 3.02, 95% CI 2.02-4.52).

Conclusions: Both asymptomatic and clinical malaria were independent risk factors for anaemia and functional iron deficiency (FID). The notion that asymptomatic and clinical malaria were associated with both anaemia and FID underscores the need for public health programmers to consider adding mass screening and treatment for malaria to existing school-based health programmes.

Keywords: Anaemia; Clinical malaria; Inflammation; Iron status; Malawi; Parasitemia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Describes the survey sampling design
Fig. 2
Fig. 2
Describes the specimen volumes and testing approaches
Fig. 3
Fig. 3
Descriptive results of the outcome and main explanatory variables
See this image and copyright information in PMC

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References

    1. Daru J, Colman K, Stanworth SJ, De La Salle B, Wood EM, Pasricha S-R. Serum ferritin as an indicator of iron status: what do we need to know? Am J Clin Nutr. 2017;106:1634S–1639S. doi: 10.3945/ajcn.117.155960. - DOI - PMC - PubMed
    1. Ramachandran N. Persisting undernutrition in India. Causes, consequences and possible solutions. New Delhi: Springer; 2014.
    1. World Health Organization (WHO) Iron deficiency anaemia assessment, prevention, and control: a guide for programme managers. Geneva: World Health Organization; 2001.
    1. Jeremiah ZA, Uko EK, Buseri FI, Adias TC. Baseline iron status of apparently healthy children in Port Harcourt, Nigeria. Eur J Gen Med. 2007;4:161–164.
    1. Kloub MN, Yassin MA. Oral iron therapy-induced neutropenia in patient with iron deficiency anemia. Case Rep Oncol. 2020;13:721–724. doi: 10.1159/000507730. - DOI - PMC - PubMed