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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.

Original publication

DOI

10.1038/s41467-019-08775-0

Type

Journal

Nature communications

Publication Date

20/02/2019

Volume

10

Addresses

Department of Epidemiology and Demography, KEMRI/Wellcome Trust Research Programme, PO Box 230, Kilifi, 80108, Kenya.

Keywords

Humans, Plasmodium falciparum, Bacteremia, Malaria, Falciparum, Sickle Cell Trait, Malnutrition, Hemoglobin, Sickle, Patient Admission, Odds Ratio, Case-Control Studies, Genotype, Child, Preschool, Infant, Disease Resistance