Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa

Amanda Garrison, Babak Khoshnood, David Courtin, Jacqueline Milet, André Garcia, Achille Massougbodji, Pierre Ayotte, Michel Cot, Florence Bodeau-Livinec, Amanda Garrison, Babak Khoshnood, David Courtin, Jacqueline Milet, André Garcia, Achille Massougbodji, Pierre Ayotte, Michel Cot, Florence Bodeau-Livinec

Abstract

Lead and malaria both present significant health risks to children in Sub-Saharan Africa. Previous studies have shown that high blood lead levels in children act as a protective factor against subsequent malaria incidence. The main objective of this study was to investigate associations between blood lead level and malaria outcomes prospectively in Beninese children from 12 to 24 months of age. Two-hundred and four children were assessed for lead at 12 months and closely followed until 24 months for malaria; when symptoms and parasite density were also recorded. Univariate and multivariate negative binomial and linear regression models tested associations between blood lead level quartile and total episodes of malaria (total symptomatic and asymptomatic episodes) and parasite density, respectively. Median blood lead level among children measured at 12 months was 56.50 (4.81-578) μg/L. During the 12-month follow-up, 172 (84.31%) children had at least one malaria episode. Univariate and multivariate negative binomial and linear regressions did not reveal significant associations between blood lead level quartile and malaria outcomes. Iron deficiency was not found to be an effect modifier. Results from this prospective child-cohort study investigating associations between blood lead level and malaria did not confirm results from previous cross-sectional studies. Further research is needed to further explore this relationship and other co-morbidities due to malaria and lead.

Trial registration: ClinicalTrials.gov NCT00811421.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Population follow-up.
Fig 1. Population follow-up.
Follow-up of participating children from birth to 24 months of age.
Fig 2. Proportion of children diagnosed with…
Fig 2. Proportion of children diagnosed with malaria and parasite densities each month of follow-up.

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