Title : Effect of iron fortification on anaemia and risk of malaria among Ghanaian pre-school children with haemoglobinopathies and different ABO blood groups
Abstract:
Introduction:
Haemoglobinopathies, such as sickle cell disorder and glucose-6-phosphate dehydrogenase (G6PD) deficiency, as well as differences in ABO blood groups, influence the risk of malaria and anaemia in malaria-endemic areas. However, the association between long-term iron fortification and host genetic factors on malaria-induced anaemia susceptibility is unknown
Objective:
This study investigated the impact of iron-containing micronutrient powder (MNP) added to weaning meals on anaemia and malaria risk in Ghanaian preschool children, considering the influence of haemoglobinopathies and ABO blood groups.
Method:
This double-blind, randomized cluster trial evaluated the effects of iron-containing vs. non-iron micronutrient powder (MNP) on malaria and haemoglobin levels in 860 Ghanaian infants aged 6-35 months, with ABO blood grouping and genotyping performed to assess genetic influences.
Results:
The prevalence of G6PD deficiency was 11.2%, higher in hemizygous males (8.5%) than homozygous females (2.7%) (p = 0.005). Sickle cell traits (HbAS and HbSC) and disorder (HbSS) prevalence were 17.5% and 0.5%, respectively. Blood group O was the most common (41.4%), followed by A (29.6%), B (23.3%), and AB (5.7%). Children with HbAS on iron supplementation had significantly moderate anaemia at endline (EL) compared to baseline (BL) (p = 0.004). Those with HbAS, HbAC, and blood groups A and O in the iron group had more malaria episodes at EL than BL (p < 0.05).
Conclusion:
Iron supplementation was linked to increased anaemia in HbAS children and reduced malaria protection in HbAC and AS children, including participants with blood groups A and O. Therefore, iron supplementation in children with certain haemoglobinopathies and blood groups may necessitate careful consideration to balance the benefits and risks.
