Format

Send to

Choose Destination
PLoS One. 2017 Aug 30;12(8):e0183977. doi: 10.1371/journal.pone.0183977. eCollection 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.

Author information

1
Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
2
Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda.
3
Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America.
4
Department of Pediatrics, University School of Medicine, Minneapolis, Minnesota, United States of America.
5
Department of Pediatrics, Indiana University, Indianapolis, Indiana, United States of America.

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 smear-confirmed malaria and iron deficiency [zinc protoporphyrin (ZPP > = 80 ╬╝mol/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.

PMID:
28854208
PMCID:
PMC5576757
DOI:
10.1371/journal.pone.0183977
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center