Background and Aims In Ghana, 74/1,000 children per year die before their fifth birthday and many suffer from ill health. We explore the relative impact of genetic traits for the children’s health.
Methods Within a trial on Intermittent Preventive Treatment in Infants for malaria 1,070 infants were recruited at 3 months and followed-up for 21 months in the Ashanti region. Each month standardized medical history, clinical exam and parasite density were taken. Anthropometric measures were performed every 3 months. DNA preparation and genotyping were performed according to standardized protocols. We defined “health” as a lack of malaria episodes with high parasitaemia, no episodes of anemia, no reporting of severe events like measles, accidents, burns, pneumonia, and normal WHO-growth standards during the entire study phase. We tested the association between health and genetic traits in multivariable logistic regression analyses adjusted for socioeconomic, spatial and clinical data.
Results As expected, children with sickle cell trait (HbAS) were more likely to grow up healthy (OR=2.89, 95%-CI=1.59–5.24). This effect was less pronounced for carriers of HbAC (hemoglobin C). The CD74 gene SNP rs7709772AG was associated with health (OR=8.00, 95%-CI=1.76–36.29). This gene encodes for a membrane protein which is important for the regulation of immune responses against infectious diseases. α-thalassemia was not related to health in multivariate analyses.
Conclusions Independently of socioeconomic and geographic factors, genetic traits that influence the risks for malaria and other infectious diseases may affect children’s health in an endemic area. This information can be relevant for the development of treatments.