ArticleMalaria journal2020
Associations between red blood cell variants and malaria among children and adults from three areas of Uganda: a prospective cohort study.
Article in Malaria journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Exploring the protective effects of thalassemia against malaria in Africa: a systematic review.Systematic reviews · 2026Pooled it
- Sickle cell haemoglobin status shapes malaria parasite genotype in asymptomatic infections.Nature microbiology · 2026Article
- The Association Between Malaria Parasite Geometrical Mean and Clinical Spectrum of Severe Disease in a High-Transmission Setting in Eastern Uganda: A Cross-Sectional Study.Journal of parasitology research · 2025Article
- The global role of G6PD in infection and immunity.Frontiers in immunology · 2024Review
- Decreased parasite burden and altered host response in children with sickle cell anemia and severe anemia with malaria.Blood advances · 2021Article
- Higher gametocyte production and mosquito infectivity in chronic compared to incident Plasmodium falciparum infections.Nature communications · 2021Article
- Sickle Cell Trait Modulates the Proteome and Phosphoproteome ofFrontiers in cellular and infection microbiology · 2021Article
- Memory CD8Clinical & translational immunology · 2021Article
- Association between haematological parameters and sickle cell genotypes in children with Plasmodium falciparum malaria resident in Kisumu County in Western Kenya.BMC infectious diseases · 2020Article
- A novel population of memory-activated natural killer cells associated with low parasitaemia inClinical & translational immunology · 2020Article
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Authors and funding
14 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundMultiple red blood cell (RBC) variants appear to offer protection against the most severe forms of Plasmodium falciparum malaria. Associations between these variants and uncomplicated malaria are less clear.
methodsData from a longitudinal cohort study conducted in 3 sub-counties in Uganda was used to quantify associations between three red blood cell variants Hb [AA, AS, S (rs334)], alpha thalassaemia 3.7 kb deletion, and glucose-6-phosphate dehydrogenase deficiency A-(G6PD 202A genotype) and malaria incidence, parasite prevalence, parasite density (a measure of anti-parasite immunity) and body temperature adjusted for parasite density (a measure of anti-disease immunity). All analyses were adjusted for age, average household entomological inoculation rate, and study site. Results for all variants were compared to those for wild type genotypes.
resultsIn children, HbAS was associated, compared to wild type, with a lower incidence of malaria (IRR = 0.78, 95% CI 0.66-0.92, p = 0.003), lower parasite density upon infection (PR = 0.66, 95% CI 0.51-0.85, p = 0.001), and lower body temperature for any given parasite density (- 0.13 ℃, 95% CI - 0.21, - 0.05, p = 0.002). In children, HbSS was associated with a lower incidence of malaria (IRR = 0.17, 95% CI 0.04-0.71, p = 0.02) and lower parasite density upon infection (PR = 0.31, 95% CI 0.18-0.54, p < 0.001). α-/αα thalassaemia, was associated with higher parasite prevalence in both children and adults (RR = 1.23, 95% CI 1.06-1.43, p = 0.008 and RR = 1.52, 95% CI 1.04-2.23, p = 0.03, respectively). G6PD deficiency was associated with lower body temperature for any given parasite density only among male hemizygote children (- 0.19 ℃, 95% CI - 0.31, - 0.06, p = 0.003).
conclusionRBC variants were associated with non-severe malaria outcomes. Elucidation of the mechanisms by which they confer protection will improve understanding of genetic protection against malaria.
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