Evidence map›Paper›PMID 39208451›Full record

ArticleThe Journal of infectious diseases2025

Circulating Immune Complexes and Glucose-6-Phosphate Dehydrogenase Deficiency Predict Recurrent Blackwater Fever in Ugandan Children With Severe Malaria.

Ruth Namazzi, Kagan A Mellencamp, Robert O Opoka, Dibyadyuti Datta, Giselle Lima-Cooper, Claire Liepmann, Julian Sherman, Ana Rodriguez, Caroline Kazinga, Russell E Ware and 6 more

Abstract read
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ruth NamazziDepartment of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
Kagan A MellencampRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Robert O OpokaDepartment of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
Dibyadyuti DattaRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-1693-935X
Giselle Lima-CooperRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Claire LiepmannRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Julian ShermanNew York University School of Medicine, New York, New York, USA.
Ana RodriguezNew York University School of Medicine, New York, New York, USA.
Caroline KazingaGlobal Health Uganda, Kampala, Uganda.
Russell E WareDivision of Hematology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Michael G GoingsRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Marcus LacerdaFundação de Medicina Tropical Dr Heitor Vieira Dourado and Instituto de Pesquisa Leônidas e Maria Deane, Fiocruz, Manaus, Amazonas, Brazil.ORCID 0000-0003-3374-9985
Marco AbreuDepartment of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Tae-Hwi Schwantes-AnDepartment of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Chandy C JohnRyan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Andrea L ConroyGlobal Health Uganda, Kampala, Uganda.ORCID 0000-0002-5328-6511

Funding

Severe Malaria And Risk to The Brain (SMART Brain)R01NS055349 · NINDS · UNIVERSITY OF MINNESOTA · PI Chandy C. John, Ruth Namazzi · 2008 to 2026
$11.2M
Research training in infection, nutrition and neurodevelopment in UgandaD43TW010928 · FIC · INDIANA UNIVERSITY INDIANAPOLIS · PI Chandy C. John · 2018 to 2026
$1.9M
Indiana University Kidney Training Program (IU-KTP)T32DK120524 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI MOE, SHARON M · 2019 to 2023
$1.3M
Mechanisms of acute kidney injury in malaria - Resubmission - 1R21AI151349 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI RODRIGUEZ, ANA · 2021 to 2022
$476k
FIC NIH HHS D43 TW010928National Institute of Diabetes and Digestive and Kidney Disease T32DK120524National Institutes of Allergy and Infectious Diseases R21AI151349NIAID NIH HHS R21 AI151349NIDDK NIH HHS T32 DK120524NIH HHSNINDS NIH HHS R01 NS055349NINDS NIH HHS R01NS055349Ralph W. and Grace M. Showalter
6 · The paper itself

Abstract

backgroundRecently, there has been an unexplained increase in the incidence of blackwater fever (BWF) in Eastern Uganda. In this study, we evaluated the association between immune complexes, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and the occurrence and recurrence of BWF in children with severe malaria (SM).

methodsBetween 2014 and 2017, children aged 6 months to <4 years hospitalized with SM and community children (CC) were recruited at 2 hospitals in Central and Eastern Uganda. We measured serum circulating immune complexes (cIC) and their relationship to SM complications and postdischarge outcomes, and evaluated effect mediation through G6PD deficiency.

resultsIn total, 557 children with SM and 101 CC were enrolled. The mean age was 2.1 years. Children with SM had higher cIC levels than CC (P < .001). After controlling for age, sex, and site, cIC were associated with severe anemia, jaundice, and BWF: adjusted odds ratio (aOR), 7.33 (95% confidence interval [CI], 3.45-15.58), P < .0001; aOR, 4.31 (95% CI, 1.68-11.08), P = .002; and aOR, 5.21 (95% CI, 2.06-13.18), P < .0001, respectively. cIC predicted readmissions for SM, severe anemia, and BWF: adjusted incidence rate ratios (aIRR), 2.11 (95% CI, 1.33-3.34), P = .001; aIRR, 8.62 (95% CI, 2.80-26.59), P < .0001; and aIRR, 7.66 (95% CI, 2.62-22.45), P < .0001, respectively. The relationship was most evident in boys where the frequency of the G6PD African allele (A-) was 16.8%. G6PD deficiency was associated with increases in cIC in boys (P = .01) and mediation analysis suggested G6PD deficiency contributes to recurrent severe anemia and BWF via increased cIC.

conclusionsImmune complexes are associated with hemolytic complications and predict recurrences in SM survivors.

Indexed as

Blackwater FeverGlucosephosphate Dehydrogenase DeficiencyMalariaChild, PreschoolFemaleGlucosephosphate DehydrogenaseHumansIncidenceInfantMaleRecurrenceUgandaGlucosephosphate Dehydrogenaseanemiablackwater feverG6PDimmune complexesmalaria

Identifiers

PMID39208451
PMCPMC12349948

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.