16/01/06

Iron supplements ‘increase malaria threat’

Copyright: CDC

By: Talent Ng’andwe

We encourage you to republish this article online and in print, it’s free under our creative commons attribution license, but please follow some simple guidelines:

You have to credit our authors.
You have to credit SciDev.Net — where possible include our logo with a link back to the original article.
You can simply run the first few lines of the article and then add: “Read the full article on SciDev.Net” containing a link back to the original article.
If you want to also take images published in this story you will need to confirm with the original source if you're licensed to use them.
The easiest way to get the article on your site is to embed the code below.

For more information view our media page and republishing guidelines.

The full article is available here as HTML.

Press Ctrl-C to copy

<div class="article-wrap">
<div id="article-introduction">
<h1>Iron supplements ‘increase malaria threat’</h1>
<h4>By: Talent Ng’andwe</h4>
</div>
<br />
<br />

<div id="article-body">
<p><P>Children at risk of malaria are more likely to die of the disease if they are given dietary supplements of iron and folic acid, according to a study in the latest issue of <em>The Lancet</em>.</P><br />
<P>The researchers who carried out the study say the World Health Organization (WHO) needs to revise its guidelines on iron supplements as a result of their findings. </P><br />
<P>The WHO says all children in areas where anaemia is a problem should be given the supplements. Anaemia is a blood disease that can stunt mental and physical development and is usually caused by eating too little iron.</P><br />
<P>But this has been controversial as some research suggests that iron deficiency can protect against malaria.</P><br />
<P>Robert Black of Johns Hopkins University, United States, and colleagues gave more than 24,000 Tanzanian children under three either a placebo or a supplement of iron and folic acid every day for a year and a half.</P><br />
<P>The study showed that only children who had anaemia because of iron deficiency benefited from the supplement. </P><br />
<P>Generally, however, children receiving iron and folic acid had a 12 per cent greater risk of being hospitalised or dying. The difference was big enough to make the researchers end the trial early.</P><br />
<P>A parallel trial also published in <em>The Lancet</em> last week showed that in Nepal, where malaria is rare, infants who received the supplements were no more likely to die than those who did not.</P><br />
<P>Putting the two studies together, Black’s team concludes that iron deficient and anaemic children can benefit from the supplements as long as there are active programmes in place to detect and treat malaria and other infections.</P><br />
<P>But they warn that giving the supplements to infants who are not iron deficient would be harmful.</P><br />
<P>“Such studies are rare and the study teams are to be applauded,” write Mike English and Robert Snow of the Kenya Medical Research Institute and Wellcome Trust Collaborative Programme, in an accompanying article in <em>The Lancet</em>. </P><br />
<P>Both papers “are far superior to any previous examination of the survival benefits and risks of supplementation with iron and [folic acid]”, they add.</P><br />
<P>English and Snow say the risks associated with giving the supplements to children exposed to malaria “seem to outweigh any immediate benefits”.</P><br />
<P>Anaemia is widespread in the developing world and is especially common in children younger than five years.</P><br />
<P><a  href="http://www.thelancet.com/journals/lancet/article/PIIS0140673606679622/fulltext" target="_blank" onclick="pageTracker._trackPageview('/tracking/external/'+this.href);" rel="noopener noreferrer">Link to full paper in <EM>The Lancet </EM>(Tanzania)</A><BR>Reference: <em>The Lancet </em>367, 133 (2006)</P><br />
<P><a  href="http://www.thelancet.com/journals/lancet/article/PIIS0140673606679634/fulltext" target="_blank" onclick="pageTracker._trackPageview('/tracking/external/'+this.href);" rel="noopener noreferrer">Link to full paper in <EM>The Lancet </EM>(Nepal)</A><BR>Reference: <em>The Lancet </em>367, 144 (2006)</P><br />
<P><a  href="http://www.thelancet.com/journals/lancet/article/PIIS0140673606679397/fulltext" target="_blank" onclick="pageTracker._trackPageview('/tracking/external/'+this.href);" rel="noopener noreferrer">Link to full article by English and Snow in <em>The Lancet</em></A><BR>Reference: <em>The Lancet </em>367, 90 (2006)</P></p>

</div>
<div class="quick-links-wrapper">
<h3>You might also like</h3>
[related-articles]
</div>
<p>This article was originally published on <a href="https://www.scidev.net" target="_blank">SciDev.Net</a>. Read the <a href="https://www.scidev.net/sub-saharan-africa/news/iron-supplements-increase-malaria-threat-ssa/" target="_blank">original article</a>.</p>
<script type="text/javascript">
(function(e,t,n,r,i,s,o){e["GoogleAnalyticsObject"]=i;e[i]=e[i]||function(){(e[i].q=e[i].q||[]).push(arguments)},e[i].l=1*new Date;s=t.createElement(n),o=t.getElementsByTagName(n)[0];s.async=1;s.src=r;o.parentNode.insertBefore(s,o)})(window,document,"script","//www.google-analytics.com/ga.js","ga");var _gaq=_gaq||[];var _gaq=_gaq||[];_gaq.push(["_setAccount","UA-3223906-8"],["_trackEvent","article interaction","republished","https://www.scidev.net/sub-saharan-africa/news/iron-supplements-increase-malaria-threat-ssa/",null,true])
</script>
</div>

Children at risk of malaria are more likely to die of the disease if they are given dietary supplements of iron and folic acid, according to a study in the latest issue of The Lancet.

The researchers who carried out the study say the World Health Organization (WHO) needs to revise its guidelines on iron supplements as a result of their findings.

The WHO says all children in areas where anaemia is a problem should be given the supplements. Anaemia is a blood disease that can stunt mental and physical development and is usually caused by eating too little iron.

But this has been controversial as some research suggests that iron deficiency can protect against malaria.

Robert Black of Johns Hopkins University, United States, and colleagues gave more than 24,000 Tanzanian children under three either a placebo or a supplement of iron and folic acid every day for a year and a half.

The study showed that only children who had anaemia because of iron deficiency benefited from the supplement.

Generally, however, children receiving iron and folic acid had a 12 per cent greater risk of being hospitalised or dying. The difference was big enough to make the researchers end the trial early.

A parallel trial also published in The Lancet last week showed that in Nepal, where malaria is rare, infants who received the supplements were no more likely to die than those who did not.

Putting the two studies together, Black’s team concludes that iron deficient and anaemic children can benefit from the supplements as long as there are active programmes in place to detect and treat malaria and other infections.

But they warn that giving the supplements to infants who are not iron deficient would be harmful.

“Such studies are rare and the study teams are to be applauded,” write Mike English and Robert Snow of the Kenya Medical Research Institute and Wellcome Trust Collaborative Programme, in an accompanying article in The Lancet.

Both papers “are far superior to any previous examination of the survival benefits and risks of supplementation with iron and [folic acid]”, they add.

English and Snow say the risks associated with giving the supplements to children exposed to malaria “seem to outweigh any immediate benefits”.

Anaemia is widespread in the developing world and is especially common in children younger than five years.

Link to full paper in The Lancet (Tanzania)
Reference: The Lancet 367, 133 (2006)

Link to full paper in The Lancet (Nepal)
Reference: The Lancet 367, 144 (2006)

Link to full article by English and Snow in The Lancet
Reference: The Lancet 367, 90 (2006)