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Prevalence of inherited blood disorders and associations with malaria and anemia in Malawian children

McGann, Patrick T.; Williams, Anne M.; Ellis, Graham; McElhinney, Kathryn E.; Romano, Laurel; Woodall, Julia; Howard, Thad A.; Tegha, Gerald; Krysiak, Robert; Lark, R. Murray; Ander, E. Louise; Mapango, Carine; Ataga, Kenneth I.; Gopal, Satish; Key, Nigel S.; Ware, Russell E.; Suchdev, Parminder S.

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Patrick T. McGann

Anne M. Williams

Graham Ellis

Kathryn E. McElhinney

Laurel Romano

Julia Woodall

Thad A. Howard

Gerald Tegha

Robert Krysiak

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Professor of Geoinformatics

E. Louise Ander

Carine Mapango

Kenneth I. Ataga

Satish Gopal

Nigel S. Key

Russell E. Ware

Parminder S. Suchdev


© 2018 American Society of Hematology. In sub-Saharan Africa, inherited causes of anemia are common, but data are limited regarding the geographical prevalence and coinheritance of these conditions and their overall contributions to childhood anemia. To address these questions in Malawi, we performed a secondary analysis of the 2015-2016 Malawi Micronutrient Survey, a nationally and regionally representative survey that estimated the prevalence of micronutrient deficiencies and evaluated both inherited and noninherited determinants of anemia. Children age 6 to 59 months were sampled from 105 clusters within the 2015-2016 Malawi Demographic Health Survey. Hemoglobin, ferritin, retinol binding protein, malaria, and inflammatory biomarkers were measured from venous blood. Molecular studies were performed using dried blood spots to determine the presence of sickle cell disease or trait, a-thalassemia trait, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Of 1279 eligible children, 1071 were included in the final analysis. Anemia, iron deficiency, and malaria were common, affecting 30.9%, 21.5%, and 27.8% of the participating children, respectively. a-Thalassemia trait was common (.40% of children demonstrating deletion of 1 [33.1%] or 2 [10.0%] a-globin genes) and associated with higher prevalence of anemia (P, .001). Approximately 20% of males had G6PD deficiency, which was associated with a 1.0 g/dL protection in hemoglobin decline during malaria infection (P 5 .02). These data document that inherited blood disorders are common and likely play an important role in the prevalence of anemia and malaria in Malawian children.

Journal Article Type Article
Acceptance Date Sep 10, 2018
Online Publication Date Nov 13, 2018
Publication Date Nov 13, 2018
Deposit Date Nov 16, 2018
Publicly Available Date Nov 16, 2018
Journal Blood Advances
Electronic ISSN 2473-9537
Publisher American Society of Hematology
Peer Reviewed Peer Reviewed
Volume 2
Issue 21
Pages 3035-3044
Public URL
Publisher URL


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