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The ferroportin Q248H mutation protects from anemia, but not malaria or bacteremia

Researchers have shown that the iron export mutation (Q248H) that primarily occurs in populations of African ancestry may protect from iron deficiency and anemia. In contrast to previously published work (Zhang et al. 2018), their work using data for over 18,000 children show that there is little evidence that the mutation protects against malaria nor […]
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Royal Society of Tropical Medicine and Hygiene Chalmers Medal Winner – 2019

Congratulations to Dr. Sam Kinyanjui who was named winner of the 2019 Royal Society of Tropical Medicine and Hygiene Chalmers Medal. This honour was announced at the 11th European Congress on Tropical Medicine and International Health held in Liverpool. The award was in recognition of Dr. Kinyanjui’s exemplary efforts to revolutionize capacity building in young […]
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The Clinical Profile of Severe Pediatric Malaria in an Area Targeted for Routine RTS,S/AS01 Malaria Vaccination in Western Kenya

BACKGROUND: The malaria prevalence has declined in western Kenya, resulting in the risk of neurological phenotypes in older children. This study investigates the clinical profile of pediatric malaria admissions ahead of the introduction of the RTS,S/AS01 vaccine. METHODS: Malaria admissions in children aged 1 month to 15 years were identified from routine, standardized, inpatient clinical surveillance data collected between 2015 and 2018 from 4 hospitals in western Kenya. Malaria phenotypes were defined based on available data. RESULTS: There were 5766 malaria admissions documented. The median age was 36 months (interquartile range, 18-60): 15% were aged between 1-11 months of age, 33% were aged 1-23 months of age, and 70% were aged 1 month to 5 years. At admission, 2340 (40.6%) children had severe malaria: 421/2208 (19.1%) had impaired consciousness, 665/2240 (29.7%) had an inability to drink or breastfeed, 317/2340 (13.6%) had experienced 2 or more convulsions, 1057/2340 (45.2%) had severe anemia, and 441/2239 (19.7%) had severe respiratory distress. Overall, 211 (3.7%) children admitted with malaria died; 163/211 (77% deaths, case fatality rate 7.0%) and 48/211 (23% deaths, case fatality rate 1.4%) met the criteria for severe malaria and nonsevere malaria at admission, respectively. The median age for fatal cases was 33 months (interquartile range, 12-72) and the case fatality rate was highest in those unconscious (44.4%). CONCLUSIONS: Severe malaria in western Kenya is still predominantly seen among the younger pediatric age group and current interventions targeted for those <5 years are appropriate. However, there are increasing numbers of children older than 5 years admitted with malaria, and ongoing hospital surveillance would identify when interventions should target older children.
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