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

2015; Oxford University Press; Volume: 212; Issue: 11 Linguagem: Inglês

10.1093/infdis/jiv308

1537-6613

Mark A. Travassos, Drissa Coulibaly, Matthew B. Laurens, Ahmadou Dembélé, Youssouf Tolo, Abdoulaye K. Koné, Karim Traoré, Amadou Niangaly, Aldiouma Guindo, Yukun Wu, Andrea A. Berry, Christopher G. Jacob, Shannon Takala‐Harrison, Matthew Adams, Biraj Shrestha, Amy Z. Mu, Bouréma Kouriba, Kirsten E. Lyke, Dapa A. Diallo, Ogobara K. Doumbo, Christopher V. Plowe, Mahamadou A. Théra,

Malaria Research and Control

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 clinical malaria than children with hemoglobin AA.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.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.Both hemoglobin C 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.