α+-thalassemia protects African children from severe malaria

Frank P. Mockenhaupt, Stephan Ehrhardt, Sabine Gellert, Rowland N. Otchwemah, Ekkehart Dietz, Sylvester D. Anemana, Ulrich Bienzle

Research output: Contribution to journalArticle

Abstract

The high frequency of α+-thalassemia in malaria-endemic regions may reflect natural selection due to protection from potentially fatal severe malaria. In Africa, bearing 90% of global malaria morbidity and mortality, this has not yet been observed. We tested this hypothesis in an unmatched case-control study among 301 Ghanaian children with severe malaria and 2107 controls (62% parasitemic). In control children, α+- thalassemia affected neither prevalence nor density of Plasmodium falciparum. However, heterozygous α+-thalassemia was observed in 32.6% of controls but in only 26.2% of cases (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.56-0.98). Protection against severe malaria was found to be pronounced comparing severe malaria patients with parasitemic controls (adjusted OR in children < 5 years of age, 0.52; 95% CI, 0.34-0.78) and to wane with age. No protective effect was discernible for homozygous children. Our findings provide evidence for natural selection of α+-thalassemia in Africa due to protection from severe malaria.

Original languageEnglish (US)
Pages (from-to)2003-2006
Number of pages4
JournalBlood
Volume104
Issue number7
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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  • Cite this

    Mockenhaupt, F. P., Ehrhardt, S., Gellert, S., Otchwemah, R. N., Dietz, E., Anemana, S. D., & Bienzle, U. (2004). α+-thalassemia protects African children from severe malaria. Blood, 104(7), 2003-2006. https://doi.org/10.1182/blood-2003-11-4090