{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T13:58:51Z","timestamp":1770472731735,"version":"3.49.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background of the study<\/jats:title>\n<jats:p>Malaria is a paramount health concern mostly among infants and young children. The World Health Organization recommends iron fortification for children with iron deficiency anaemia living in malaria-endemic regions like Ghana. However, the intricate interplay between genetic polymorphisms and nutritional interventions in malaria susceptibility and severity remains unclear. The Human Leukocyte Antigen-G (<jats:italic>HLA-G)<\/jats:italic> locus within the Major Histocompatibility Complex (MHC) genes has surfaced as a critical player in regulating immune responses and influencing disease outcomes. Therefore, we aimed to evaluate the effect of <jats:italic>HLA-G 14<\/jats:italic> bp polymorphism and its associated risk of malaria severity among Ghanaian infants and young children on iron fortification.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>This secondary double-blinded cluster randomized controlled trial involved 432 archival samples from the Tain District and Wenchi Municipal in the Bono Region. Participants aged between 6 and 36 months and consuming semi-solid foods were recruited in the study while children with malaria infection or other known medical conditions were excluded. Capillary blood samples were taken for anaemia determination using a haematology autoanalyzer, malaria infection status, and parasitaemia were assessed via microscopy, and <jats:italic>HLA-G 14<\/jats:italic> bp polymorphism using PCR. Hardy-Weinberg equilibrium and multivariate regression models were used to analyze the data obtained.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The research findings indicate that among the iron-fortified children with <jats:italic>HLA-G, 14<\/jats:italic> bp\u2009+\u2009\/- and 14 bp-\/- variants are likely to develop severe malaria. Also, the <jats:italic>HLA-G <jats:italic>14<\/jats:italic><\/jats:italic> bp\u2009+\u2009\/- variant was linked to a higher risk of anaemia development among participants who received iron supplements.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The study results indicated that iron-fortified individuals carrying the <jats:italic>HLA-G 14<\/jats:italic> bp insertion\/deletion polymorphism have an elevated risk of developing severe malaria, which in turn predisposes them to anaemia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0322524","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:31:32Z","timestamp":1757957492000},"page":"e0322524","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["HLA-G 14\u2009bp polymorphism: Implications and its associated risk to malaria severity among iron-fortified Ghanaian infants and young children"],"prefix":"10.1371","volume":"20","author":[{"given":"Adjoa","family":"Tetteh Danquah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Courtin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Asamoah Sakyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon Kwesi","family":"Nakotey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4800-1769","authenticated-orcid":true,"given":"Samuel Kofi","family":"Tchum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Afriyie Duah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6182-5367","authenticated-orcid":true,"given":"Alis\u00e9","family":"Lagrave","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1155-4730","authenticated-orcid":true,"given":"Christian","family":"Sewor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4086-3033","authenticated-orcid":true,"given":"Benjamin","family":"Amoani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"pone.0322524.ref001","volume-title":"World malaria 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