Oral iron supplements for children in malaria-endemic areas - PubMed (original) (raw)
Review
Oral iron supplements for children in malaria-endemic areas
Joseph U Okebe et al. Cochrane Database Syst Rev. 2011.
Update in
- Oral iron supplements for children in malaria-endemic areas.
Neuberger A, Okebe J, Yahav D, Paul M. Neuberger A, et al. Cochrane Database Syst Rev. 2016 Feb 27;2(2):CD006589. doi: 10.1002/14651858.CD006589.pub4. Cochrane Database Syst Rev. 2016. PMID: 26921618 Free PMC article. Review.
Abstract
Background: Iron-deficiency anaemia is common during childhood. Iron supplementation has been claimed to increase the risk of malaria.
Objectives: To assess the effect of iron on malaria and deaths.
Search strategy: We searched The Cochrane Library, PUBMED, MEDLINE, LILACS; and trial registry databases, all up to June 2011. We scanned references of included trials.
Selection criteria: Individually and cluster randomized controlled trials conducted in hypoendemic to holoendemic malaria regions and including children below 18 years of age. We included trials comparing orally administered iron, iron with antimalarial treatment, or iron with folic acid versus placebo or no treatment. Iron fortification was excluded. Antihelminthics could be administered to either group. Additional micronutrients had to be administered equally to both groups.
Data collection and analysis: The primary outcomes were clinical (symptomatic) malaria, severe malaria, and death. Two authors independently selected the studies and extracted the data. We assessed heterogeneity and conducted subgroup analyses by the presence of anaemia at baseline, age, and malaria endemicity. We assessed risk of bias using domain-based evaluation. We performed a fixed-effect meta-analysis for all outcomes and random-effects meta-analysis for hematological outcomes. We adjusted analyses for cluster randomized trials.
Main results: Seventy-one trials (45,353 children) were included. For clinical malaria, no significant difference between iron alone and placebo was detected, (risk ratio (RR) 0.99, 95% confidence intervals (CI) 0.90 to 1.09, 13 trials). The results were similar in the subgroups of non-anaemic children and children below 2 years of age. There was no significant difference in deaths in hyper- and holoendemic areas, risk difference +1.93 per 1000 children (95% CI -1.78 to 5.64, 13 trials, 17,898 children). Iron administered for treatment of anaemia resulted in a larger increase in haemoglobin than iron given for prevention, and the benefit was similar in hyper- or holoendemic and lower endemicity settings. Iron and folic acid supplementation resulted in mixed results for severe malaria. Overall, the risk for clinical malaria was higher with iron or with iron plus folic acid in trials where services did not provide for malaria surveillance and treatment. Iron with antimalarial treatment significantly reduced malaria. Iron supplementation during an acute attack of malaria did not increase the risk for parasitological failure, (RR 0.96, 95% CI 0.74 to 1.24, three trials) or deaths.
Authors' conclusions: Iron alone or with antimalaria treatment does not increase the risk of clinical malaria or death when regular malaria surveillance and treatment services are provided. There is no need to screen for anaemia prior to iron supplementation.
Update of
- Oral iron supplementation for preventing or treating anaemia among children in malaria-endemic areas.
Ojukwu JU, Okebe JU, Yahav D, Paul M. Ojukwu JU, et al. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006589. doi: 10.1002/14651858.CD006589.pub2. Cochrane Database Syst Rev. 2009. PMID: 19588399 Updated. Review.
Similar articles
- Oral iron supplementation for preventing or treating anaemia among children in malaria-endemic areas.
Ojukwu JU, Okebe JU, Yahav D, Paul M. Ojukwu JU, et al. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD006589. doi: 10.1002/14651858.CD006589.pub2. Cochrane Database Syst Rev. 2009. PMID: 19588399 Updated. Review. - Oral iron supplements for children in malaria-endemic areas.
Neuberger A, Okebe J, Yahav D, Paul M. Neuberger A, et al. Cochrane Database Syst Rev. 2016 Feb 27;2(2):CD006589. doi: 10.1002/14651858.CD006589.pub4. Cochrane Database Syst Rev. 2016. PMID: 26921618 Free PMC article. Review. - Nutrition-specific interventions for preventing and controlling anaemia throughout the life cycle: an overview of systematic reviews.
da Silva Lopes K, Yamaji N, Rahman MO, Suto M, Takemoto Y, Garcia-Casal MN, Ota E. da Silva Lopes K, et al. Cochrane Database Syst Rev. 2021 Sep 26;9(9):CD013092. doi: 10.1002/14651858.CD013092.pub2. Cochrane Database Syst Rev. 2021. PMID: 34564844 Free PMC article. Review. - Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review).
De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP. De-Regil LM, et al. Evid Based Child Health. 2013 Jan;8(1):112-201. doi: 10.1002/ebch.1895. Evid Based Child Health. 2013. PMID: 23878126 Review. - Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.
De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP. De-Regil LM, et al. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD008959. doi: 10.1002/14651858.CD008959.pub2. Cochrane Database Syst Rev. 2011. PMID: 21901727 Updated. Review.
Cited by
- Review of intervention products for use in the prevention and control of anemia.
Lopez de Romaña D, Mildon A, Golan J, Jefferds MED, Rogers LM, Arabi M. Lopez de Romaña D, et al. Ann N Y Acad Sci. 2023 Nov;1529(1):42-60. doi: 10.1111/nyas.15062. Epub 2023 Sep 8. Ann N Y Acad Sci. 2023. PMID: 37688369 Free PMC article. Review. - Baseline iron status and presence of anaemia determine the course of systemic Salmonella infection following oral iron supplementation in mice.
Hoffmann A, Haschka D, Valente de Souza L, Tymoszuk P, Seifert M, von Raffay L, Hilbe R, Petzer V, Moser PL, Nairz M, Weiss G. Hoffmann A, et al. EBioMedicine. 2021 Sep;71:103568. doi: 10.1016/j.ebiom.2021.103568. Epub 2021 Sep 3. EBioMedicine. 2021. PMID: 34488018 Free PMC article. - Interventions for Addressing Anemia Among Children and Adolescents: An Overview of Systematic Reviews.
Mithra P, Khatib MN, Sinha AP, Kumar N, Holla R, Unnikrishnan B, Vijayamma R, Nair NS, Gaidhane A, Quazi Zahiruddin S. Mithra P, et al. Front Pediatr. 2021 Feb 16;8:549549. doi: 10.3389/fped.2020.549549. eCollection 2020. Front Pediatr. 2021. PMID: 33665173 Free PMC article. - Nutritional Status and Humoral Immune Response to Plasmodium falciparum in Children Aged 6-59 Months.
Tepa A, Abame I, Makamta V, Fongang B, Donkeu J, Ayong L, Pieme CA. Tepa A, et al. J Trop Med. 2020 May 20;2020:1843780. doi: 10.1155/2020/1843780. eCollection 2020. J Trop Med. 2020. PMID: 32518565 Free PMC article. - Fortification of wheat and maize flour with folic acid for population health outcomes.
Centeno Tablante E, Pachón H, Guetterman HM, Finkelstein JL. Centeno Tablante E, et al. Cochrane Database Syst Rev. 2019 Jul 1;7(7):CD012150. doi: 10.1002/14651858.CD012150.pub2. Cochrane Database Syst Rev. 2019. PMID: 31257574 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical