Kemri-Wellcome Trust Research Programme: Investigating how iron might mediate the relationship between severe anaemia and invasive bacterial infections in Kenyan children

Severe anaemia and invasive bacterial infections are important causes of morbidity and death in African children. Children with severe anaemia have a high risk of bacteraemia due to non-Typhoidal Salmonella spp. (NTS) and Escherichia coli. However, little is known about the potential mechanisms underlying this association. Iron is critical for bacterial growth as well as for red cell production and cell mediated immunity. This project aims to investigate the putative iron-related factors that might underlie the association between severe anaemia and bacteraemia. I will use two approaches. Firstly, using clinical and laboratory data collected over the last 20 years I will investigate the epidemiological associations of severe anaemia with bacteraemia. I will then assay biomarkers of iron and cell-mediated immunity in children with severe anaemia and NTS or E. coli bacteraemia and controls using stored samples from the Kilifi Biobank. Secondly, I will conduct bacterial growth assays and genetic analyses for bacterial siderophores using sera with differing haemoglobin and iron levels. This project will help to elucidate key pathways in the competition for iron between the host and bacterial pathogens. A possible public health recommendation is the use of bacterial diagnostics prior to implementing iron supplementation according to guidelines.

Programme: International Masters Fellowship

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