Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 23;9(1):56.
doi: 10.1186/s40795-023-00709-w.

Effect of iron fortification on anaemia and risk of malaria among Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups

Samuel Kofi Tchum  1   2 , Samuel Asamoah Sakyi  3 , Fareed Arthur  4 , Bright Adu  5 , Latifatu Alhassan Abubakar  6 , Felix Boakye Oppong  6 , Francis Dzabeng  7 , Benjamin Amoani  8 , Thomas Gyan  6 , Kwaku Poku Asante  6
Affiliations

Effect of iron fortification on anaemia and risk of malaria among Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups

Samuel Kofi Tchum et al. BMC Nutr. .

Abstract

Background: Haemoglobinopathies such as sickle cell disorder and glucose-6-phosphate dehydrogenase (G6PD) deficiency as well as differences in ABO blood groups have been shown to influence the risk of malaria and/or anaemia in malaria-endemic areas. This study assessed the effect of adding MNP containing iron to home-made weaning meals on anaemia and the risk of malaria in Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups.

Methods: This study was a double-blind, randomly clustered trial conducted within six months among infants and young children aged 6 to 35 months in rural Ghana (775 clusters, n = 860). Participants were randomly selected into clusters to receive daily semiliquid home-prepared meals mixed with either micronutrient powder without iron (noniron group) or with iron (iron group; 12.5 mg of iron daily) for 5 months. Malaria infection was detected by microscopy, blood haemoglobin (Hb) levels were measured with a HemoCue Hb analyzer, the reversed ABO blood grouping microtube assay was performed, and genotyping was performed by PCR-RFLP analysis.

Results: The prevalence of G6PD deficiency among the study participants was 11.2%. However, the prevalence of G6PD deficiency in hemizygous males (8.5%) was significantly higher than that in homozygous females (2.7%) (p = 0.005). The prevalence rates of sickle cell traits (HbAS and HbSC) and sickle cell disorder (HbSS) were 17.5% and 0.5%, respectively. Blood group O was dominant (41.4%), followed by blood group A (29.6%) and blood group B (23.3%), while blood group AB (5.7%) had the least frequency among the study participants. We observed that children on an iron supplement with HbAS had significantly moderate anaemia at the endline (EL) compared to the baseline level (BL) (p = 0.004). However, subjects with HbAS and HbAC and blood groups A and O in the iron group had a significantly increased number of malaria episodes at EL than at BL (p < 0.05). Furthermore, children in the iron group with HbSS (p < 0.001) and the noniron group with HbCC (p = 0.010) were significantly less likely to develop malaria.

Conclusions: Iron supplementation increased anaemia in children with HbAS genotypes and provided less protection against malaria in children with HbAC and AS and blood groups A and O.

Trial registration: clinicaltrials.gov Identifier: NCT01001871 . Registered 27/10/2009.

Registration number: https://clinicaltrials.gov/ct2/show/record/NCT01001871 .

Keywords: Anaemia; Haemoglobinopathies; Iron fortification; Malaria; Polymorphisms.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic representation of study participants. Micronutrient powder (MNP), month (mo), a cluster is an identified compound with 1 or more households (or family units) residing together with at least 1 eligible child recruited into the study
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rihet P, Flori L, Tall F, Traoré AS, Fumoux F. Hemoglobin C is associated with reduced Plasmodium falciparum parasitemia and low risk of mild malaria attack. Hum Mol Genet. 2004;13(1):1–6. doi: 10.1093/hmg/ddh002. - DOI - PubMed
    1. Haldar K, Mohandas N. Malaria, erythrocytic infection, and anemia. ASH Education Program Book. 2009;2009(1):87–93. - PMC - PubMed
    1. Ahmed JS, Guyah B, Sang D, Webale MK, Mufyongo NS, Munde E, et al. Influence of blood group, Glucose-6-phosphate dehydrogenase and Haemoglobin genotype on Falciparum malaria in children in Vihiga highland of Western Kenya. BMC Infect Dis. 2020;20(1):1–8. doi: 10.1186/s12879-020-05216-y. - DOI - PMC - PubMed
    1. Heussler V, Spielmann T, Frischknecht F, Gilberger T. Plasmodium. Molecular Parasitology: Springer; 2016. pp. 241–284.
    1. Cholera R, Brittain NJ, Gillrie MR, Lopera-Mesa TM, Diakité SA, Arie T, et al. Impaired cytoadherence of Plasmodium falciparum-infected erythrocytes containing sickle hemoglobin. Proc Natl Acad Sci. 2008;105(3):991–996. doi: 10.1073/pnas.0711401105. - DOI - PMC - PubMed

Associated data