The indirect health effects of malaria estimated from health advantages of the sickle cell trait

Sophie Uyoga, Alex W. Macharia, Carolyne M. Ndila, Gideon Nyutu, Mohammed Shebe, Kennedy O. Awuondo, Neema Mturi, Norbert Peshu, Benjamin Tsofa, J. Anthony G. Scott, Kathryn Maitland and Thomas N. Williams ()
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Sophie Uyoga: KEMRI/Wellcome Trust Research Programme
Alex W. Macharia: KEMRI/Wellcome Trust Research Programme
Carolyne M. Ndila: KEMRI/Wellcome Trust Research Programme
Gideon Nyutu: KEMRI/Wellcome Trust Research Programme
Mohammed Shebe: KEMRI/Wellcome Trust Research Programme
Kennedy O. Awuondo: KEMRI/Wellcome Trust Research Programme
Neema Mturi: KEMRI/Wellcome Trust Research Programme
Norbert Peshu: KEMRI/Wellcome Trust Research Programme
Benjamin Tsofa: KEMRI/Wellcome Trust Research Programme
J. Anthony G. Scott: KEMRI/Wellcome Trust Research Programme
Kathryn Maitland: KEMRI/Wellcome Trust Research Programme
Thomas N. Williams: KEMRI/Wellcome Trust Research Programme

Nature Communications, 2019, vol. 10, issue 1, 1-7

Abstract: Abstract Most estimates of the burden of malaria are based on its direct impacts; however, its true burden is likely to be greater because of its wider effects on overall health. Here we estimate the indirect impact of malaria on children’s health in a case-control study, using the sickle cell trait (HbAS), a condition associated with a high degree of specific malaria resistance, as a proxy indicator for an effective intervention. We estimate the odds ratios for HbAS among cases (all children admitted to Kilifi County Hospital during 2000–2004) versus community controls. As expected, HbAS protects strongly against malaria admissions (aOR 0.26; 95%CI 0.22–0.31), but it also protects against other syndromes, including neonatal conditions (aOR 0.79; 0.67–0.93), bacteraemia (aOR 0.69; 0.54–0.88) and severe malnutrition (aOR 0.67; 0.55–0.83). The wider health impacts of malaria should be considered when estimating the potential added benefits of effective malaria interventions.

Date: 2019
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DOI: 10.1038/s41467-019-08775-0

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