Malaria and Age Variably but Critically Control Hepcidin Throughout Childhood in Kenya

Area of Science:

• Pediatrics
• Infectious Diseases
• Nutritional Science

Background:

• Iron deficiency (ID) and malaria are prevalent in African children.
• Hepcidin, an iron-regulatory hormone, is known to be induced by malaria, but longitudinal data are limited.

Purpose of the Study:

• To investigate the longitudinal relationship between malaria and hepcidin concentrations in Kenyan children.
• To assess the impact of malaria on iron status and the risk of future febrile illnesses.

Main Methods:

• Longitudinal study of 324 Kenyan children (≤8 years) with intensive surveillance for malaria.
• Measurement of hepcidin concentrations, iron status markers, and malaria antibody titers during two cross-sectional surveys.
• Analysis of associations between malaria status, antibody titers, and hepcidin levels.

Main Results:

• Hepcidin concentrations were highest in young infants and females, declining with age.
• Asymptomatic malaria and malaria antibody titers positively correlated with hepcidin levels.
• Febrile malaria episodes were linked to transiently high hepcidin levels, but hepcidin did not predict future illness risk.

Conclusions:

• Malaria, both symptomatic and asymptomatic, contributes to iron deficiency in African children by increasing hepcidin and impairing iron absorption.
• The effectiveness of iron supplementation may be compromised in children with asymptomatic malaria.
• Malaria prevention and elimination strategies could concurrently address a major cause of iron deficiency in this population.