Abstract:
Both iron deficiency and malaria are common in much of sub-Saharan Africa, and the interaction between
these conditions is complex. To investigate the association between nutritional iron status, immunoglobulins,
and clinical Plasmodium falciparum malaria, we determined the incidence of malaria in a cohort of children
between the ages of 8 months and 8 years who were living on the Kenyan coast. Biochemical iron status and
malaria-specific immune responses were determined during 2 cross-sectional surveys.We found that the incidence
of clinical malaria was significantly lower among iron-deficient children (incidence-rate ratio [IRR], 0.70; 95%
confidence interval [CI], 0.51–0.99; P ! .05), that the incidence of malaria was significantly associated with
plasma ferritin concentration (IRR for log ferritin concentration, 1.48; 95% CI, 1.01–2.17; P ! .05), and that
iron status was strongly associated with a range of malaria-specific immunoglobulins. We conclude that iron
deficiency was associated with protection from mild clinical malaria in our cohort of children in coastal Kenya
and discuss possible mechanisms for this protection