Iron pills don’t raise malaria risk in kids

A review of published studies indicates that the use of iron supplements to prevent iron-deficiency anemia in children does not increase the risk of malaria, even in young children who live in endemic areas, provided that regular malaria surveillance and treatment services are available.

It has been suggested that, in countries where malaria is prevalent, iron supplementation increases the risk of malaria and deaths. The high dose of iron which is given as medicine may result in free iron circulating in the blood and available to the malaria parasite, which promotes its growth.

“Based on our review, children should not be denied iron supplements, even if they are living in areas where malaria is prevalent,” Dr. Juliana Ojukwu, from Ebonyi State University, Nigeria, said in a statement.

This position, however, runs counter to current recommendations by the World Health Organization, according to the report in The Cochrane Review for July 7.

Prior to 2007, the WHO recommended iron supplements for all children to prevent deficiency and anemia, a key public health issue in developing countries.

Prompted by a recent study in Zanzibar, the WHO changed its guidelines, stating that iron supplements should not be given to children under 2 years who live in areas were malaria is a problem.

In the current review, Ojukwu’s team analyzed data from 68 relevant trials that included 42,981 children.

The main analysis found no elevated risk of malaria in iron users versus non-users.

Further analysis indicated an increased risk, but only in trials lacking malaria surveillance and treatment.

“Any potential negative effects of giving iron have to be weighed against the quite serious implications of not giving it, namely anemia and its contribution to childhood infection and death, especially in sub-Saharan African,” Ojukwu emphasized.

SOURCE: The Cochrane Library 2009.