Malaria causes long-term effects on markers of iron status in children: a critical assessment of existing clinical and epidemiological tools.

Autor: Castberg FC; Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark., Sarbah EW; Noguchi Memorial Institute for Medical Research, Accra, Ghana., Koram KA; Noguchi Memorial Institute for Medical Research, Accra, Ghana., Opoku N; Hohoe Municipality Hospital, Hohoe, Ghana.; School of Public Health, University of Health and Allied Sciences, Ho, Ghana., Ofori MF; Noguchi Memorial Institute for Medical Research, Accra, Ghana., Styrishave B; Toxicology and Drug Metabolism Group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Hviid L; Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Centre for Medical Parasitology, Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark., Kurtzhals JAL; Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. joku@sund.ku.dk.; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark. joku@sund.ku.dk.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2018 Dec 11; Vol. 17 (1), pp. 464. Date of Electronic Publication: 2018 Dec 11.
DOI: 10.1186/s12936-018-2609-6
Abstrakt: Background: Most epidemiological studies on the interplay between iron deficiency and malaria risk classify individuals as iron-deficient or iron-replete based on inflammation-dependent iron markers and adjustment for inflammation by using C-reactive protein (CRP) or α-1-acid glycoprotein (AGP). The validity of this approach and the usefulness of fibroblast growth factor 23 (FGF23) as a proposed inflammation-independent iron marker were tested.
Methods: Conventional iron markers and FGF23 were measured in children with acute falciparum malaria and after 1, 2, 4, and 6 weeks. Children, who were transfused or received iron supplementation in the follow-up period, were excluded, and iron stores were considered to be stable throughout. Ferritin levels 6 weeks after admission were used as a reference for admission iron status and compared with iron markers at different time points.
Results: There were long-term perturbations in iron markers during convalescence from acute malaria. None of the tested iron parameters, including FGF23, were independent of inflammation. CRP and AGP normalized faster than ferritin after malaria episodes.
Conclusion: Malaria may bias epidemiological studies based on inflammation-dependent iron markers. Better markers of iron status during and after inflammation are needed in order to test strategies for iron supplementation in populations at risk of malaria.
Databáze: MEDLINE
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