Delaying the start of iron until 28 days after antimalarial treatment is associated with lower incidence of subsequent illness in children with malaria and iron deficiency.

Authors

Ericka Jaramillo, Icahn School of Medicine at Mount Sinai, USA
Ezekiel Mupere, Makerere University, Uganda
Robert Opoka, Aga Khan UniversityFollow
James Hodges, University of Minnesota School of Public Health, Minneapolis, USA
Troy Lund, University School of Medicine, Minneapolis, USA
Michael Georgieff, University School of Medicine Minneapolis, USA
Chandy John, Indiana University, USA
Sarah Cusick, University School of Medicine Minneapolis, USA

Document Type

Article

Department

Paediatrics and Child Health (East Africa)

Abstract

We evaluated the incidence of all-cause and malaria-specific clinic visits during follow-up of a recent trial of iron therapy. In the main trial, Ugandan children 6–59 months with smearconfirmed malaria and iron deficiency [zinc protoporphyrin (ZPP > = 80 μmol/mol heme)] were treated for malaria and randomized to start a 27-day course of oral iron concurrently with (immediate group) or 28 days after (delayed group) antimalarial treatment. All children were followed for the same 56-day period starting at the time of antimalarial treatment (Day 0) and underwent passive and active surveillance for malaria and other morbidity for the entire follow-up period. All ill children were examined and treated by the study physician. In this secondary analysis of morbidity data from the main trial, we report that although the incidence of malaria-specific visits did not differ between the groups, children in the immediate group had a higher incidence rate ratio of all-cause sick-child visits to the clinic during the follow-up period (Incidence Rate Ratio (IRR) immediate/delayed = 1.76; 95%CI: 1.05–3.03, p = 0.033). Although these findings need to be tested in a larger trial powered for malaria-specific morbidity, these preliminary results suggest that delaying iron by 28 days in children with coexisting malaria and iron deficiency is associated with a reduced risk of subsequent all-cause illness.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Plos one

DOI

https://doi.org/10.1371/journal.pone.0183977

Recommended Citation

Jaramillo, E., Mupere, E., Opoka, R., Hodges, J., Lund, T., Georgieff, M., John, C., Cusick, S. (2017). Delaying the start of iron until 28 days after antimalarial treatment is associated with lower incidence of subsequent illness in children with malaria and iron deficiency.. Plos one, 1-8.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/512

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This work is licensed under a Creative Commons Attribution 4.0 International License.