About this item:

324 Views | 396 Downloads

Author Notes:

Correspondence: Patrick T. McGann, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 11027, Cincinnati, OH 45229; e-mail: patrick.mcgann@cchmc.org.

Contribution: P.T.M., A.M.W., C.M., and P.S.S. designed and implemented the study, analyzed the data, and wrote the first draft of the manuscript; G.E., G.T., R.K., K.I.A., S.G., and N.S.K. supported, oversaw, and performed local laboratory analyses in Malawi; K.E.M., L.R., J.W., T.A.H., and R.E.W. developed and validated laboratory techniques for genetic validation and performed advanced laboratory testing, confirming the presence or absence of each inherited blood disorder; R.M.L. and E.L.A. performed geospatial analyses and develop associated map; and all authors contributed to writing, editing and approving the final manuscript.

The authors declare no competing financial interests.


Research Funding:

The study was supported by the Emory Global Health Institute (Combating Childhood Illness Seed Grant; principal investigator: P.S.S.).

The overall Malawi Demographic Health Survey was funded by Irish Aid, World Bank, and UNICEF with technical assistance from the Centers for Disease Control and Prevention and Emory University.

P.T.M. receives funding from the National Institutes of Health, National Heart, Lung, and Blood Institute (1K23HL128885).


  • sickle cell disease
  • Malawi
  • children
  • G6PD
  • inherited blood disorders
  • anemia
  • malaria

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

Show all authors Show less authors


Journal Title:

Blood Advances


Volume 2, Number 21


, Pages 3035-3044

Type of Work:

Article | Final Publisher PDF


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, α-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. α-Thalassemia trait was common (>40% of children demonstrating deletion of 1 [33.1%] or 2 [10.0%] α-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 = .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.

Copyright information:


Export to EndNote