Effect of Iron Fortification on Anaemia and Risk of Malaria among Ghanaian Pre-School Children with Haemoglobinopathies and Different ABO Blood Groups
Abstract BackgroundHaemoglobinopathies such as sickle cell disorder and glucose-6-phosphate dehydrogenase (G6PD) deficiency as well as differences in ABO blood groups have been shown to influence the risk of malaria and/or anaemia in malaria-endemic areas. This study assessed how iron fortification in addition to weaning meals affects anaemia and the risk of malaria in Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups.MethodsThis study was a double-blind, randomly clustered trial conducted within six months among infants and young children aged 6 to 35 months in rural Ghana (775 clusters, n = 860). Participants were randomly selected into clusters to receive daily semiliquid home-prepared meals mixed with either micronutrient powder without iron (noniron group) or with iron (iron group; 12.5mg of iron daily) for 5 months. Malaria infection was detected by microscopy, blood haemoglobin (Hb) levels were measured with a HemoCue Hb analyser, the reversed ABO blood grouping microtube assay was performed, and genotyping was performed by PCR-RFLP analysis.ResultsThe prevalence of G6PD deficiency in hemizygous males (8.5%) was higher than that in homozygous females (2.7%) but was similar (p=0.668). The prevalence rates of sickle cell traits (HbAS and HbSC) and sickle cell disorder (HbSS) were 17.5% and 0.5%, respectively. Blood group O was dominant (41.4%), followed by blood group A (29.6%) and blood group B (23.3%), while blood group AB (5.7%) was the rarest among the study participants. This study observed that children on an iron supplement with HbAS had significantly moderate anaemia at the endline (EL) compared to the baseline level (BL) (p = 0.004). However, subjects with HbAS and HbAC and blood groups A and O in the iron group had a significantly increased number of malaria episodes at EL than at BL (p < 0.05). Furthermore, children in the iron group with HbSS (p < 0.001) and the noniron group with HbCC (p = 0.010) were significantly less likely to develop malaria.ConclusionsIron supplementation increased anaemia in children with HbAS genotypes but provided less protection against malaria in children with HbAC and AS and blood groups A and O.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01001871. Registered 27/10/2009, http://www. ClinicalTrials.gov/ NCT01001871.Registration number: https://clinicaltrials.gov/ct2/show/record/NCT01001871..
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Preprint| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
ResearchSquare.com - (2023) vom: 16. Okt. Zur Gesamtaufnahme - year:2023 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tchum, Samuel Kofi [VerfasserIn] |
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| doi: |
10.21203/rs.3.rs-1598062/v3 |
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XRA036150789 |
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| 245 | 1 | 0 | |a Effect of Iron Fortification on Anaemia and Risk of Malaria among Ghanaian Pre-School Children with Haemoglobinopathies and Different ABO Blood Groups |
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| 520 | |a Abstract BackgroundHaemoglobinopathies such as sickle cell disorder and glucose-6-phosphate dehydrogenase (G6PD) deficiency as well as differences in ABO blood groups have been shown to influence the risk of malaria and/or anaemia in malaria-endemic areas. This study assessed how iron fortification in addition to weaning meals affects anaemia and the risk of malaria in Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups.MethodsThis study was a double-blind, randomly clustered trial conducted within six months among infants and young children aged 6 to 35 months in rural Ghana (775 clusters, n = 860). Participants were randomly selected into clusters to receive daily semiliquid home-prepared meals mixed with either micronutrient powder without iron (noniron group) or with iron (iron group; 12.5mg of iron daily) for 5 months. Malaria infection was detected by microscopy, blood haemoglobin (Hb) levels were measured with a HemoCue Hb analyser, the reversed ABO blood grouping microtube assay was performed, and genotyping was performed by PCR-RFLP analysis.ResultsThe prevalence of G6PD deficiency in hemizygous males (8.5%) was higher than that in homozygous females (2.7%) but was similar (p=0.668). The prevalence rates of sickle cell traits (HbAS and HbSC) and sickle cell disorder (HbSS) were 17.5% and 0.5%, respectively. Blood group O was dominant (41.4%), followed by blood group A (29.6%) and blood group B (23.3%), while blood group AB (5.7%) was the rarest among the study participants. This study observed that children on an iron supplement with HbAS had significantly moderate anaemia at the endline (EL) compared to the baseline level (BL) (p = 0.004). However, subjects with HbAS and HbAC and blood groups A and O in the iron group had a significantly increased number of malaria episodes at EL than at BL (p < 0.05). Furthermore, children in the iron group with HbSS (p < 0.001) and the noniron group with HbCC (p = 0.010) were significantly less likely to develop malaria.ConclusionsIron supplementation increased anaemia in children with HbAS genotypes but provided less protection against malaria in children with HbAC and AS and blood groups A and O.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01001871. Registered 27/10/2009, http://www. ClinicalTrials.gov/ NCT01001871.Registration number: https://clinicaltrials.gov/ct2/show/record/NCT01001871. | ||
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