Mayr Wolfram, Ndong Paulin E, Alabi Ayodele, Kabwende Lumeka A, Weiss Günter, Agnandji Selidji T
Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Innsbruck, Austria.
Commun Med (Lond). 2025 Jul 22;5(1):305. doi: 10.1038/s43856-025-00988-3.
Iron deficiency, anemia, and infectious diseases contribute largely to the disease burden among children in Sub-Saharan Africa. Accurate assessment of iron status and its relationship with infections is essential for refining iron supplementation strategies.
We report retrospectively analyzed data from a cross-sectional study of children aged 2-17 years with acute febrile illness (fever ≤7 days) in Lambaréné, Gabon (NCT03047642). Symptom-based microbiological testing identified infection etiology. Blood count, C-reactive protein, iron parameters, and cytokines levels assessed iron deficiency, anemia, and immune activation.
Among 415 screened children with acute febrile illness, hemoglobin and iron parameters are available in 197. Of those, 145 (73.6%) are anemic: 53 (36.6%) show anemia of inflammation (AI), 11 (7.6%) iron-deficiency anemia (IDA), and 29 (20.0%) combined AI/IDA. Others are categorized as multifactorial, with mostly microcytic anemia, transferrin saturation (TSAT) ≥ 20% and varying ferritin levels. TSAT is negatively associated with IL-10, IL-6, and IL-2 in the malaria-positive group, with IL-10 also showing a positive correlation with parasitemia counts. In malaria-negative children with undetermined pathogens, IFN-γ and IL-4 levels are positively associated with TSAT and ferritin.
These findings highlight iron dyshomeostasis in infectious diseases and confirm associations between iron availability and immune activation to causative pathogens.
缺铁、贫血和传染病在很大程度上导致了撒哈拉以南非洲儿童的疾病负担。准确评估铁状态及其与感染的关系对于完善铁补充策略至关重要。
我们报告了对加蓬兰巴雷内2至17岁急性发热疾病（发热≤7天）儿童的横断面研究数据进行的回顾性分析（NCT03047642）。基于症状的微生物检测确定了感染病因。血细胞计数、C反应蛋白、铁参数和细胞因子水平评估了缺铁、贫血和免疫激活情况。
在415名接受筛查的急性发热疾病儿童中，197名有血红蛋白和铁参数数据。其中，145名（73.6%）贫血：53名（36.6%）表现为炎症性贫血（AI），11名（7.6%）缺铁性贫血（IDA），29名（20.0%）为AI/IDA合并症。其他则归类为多因素贫血，大多为小细胞性贫血，转铁蛋白饱和度（TSAT）≥20%且铁蛋白水平各异。在疟疾阳性组中，TSAT与IL-10、IL-6和IL-2呈负相关，IL-10也与疟原虫计数呈正相关。在病原体未确定的疟疾阴性儿童中，IFN-γ和IL-4水平与TSAT和铁蛋白呈正相关。
这些发现突出了传染病中铁稳态失衡，并证实了铁可用性与对致病病原体的免疫激活之间的关联。
