Cochrane review: Oral iron supplementation for preventing or treating anaemia among children in malaria‐endemic areas

摘要: Background Iron-deficiency anaemia is common during childhood. Iron supplementation has been claimed to increase the risk of malaria. Objectives To assess effect iron on malaria and deaths. Search strategy We searched The Cochrane Library (2009, issue 1); MEDLINE; EMBASE; LILACS metaRegister Controlled Trials, all up March 2009. We scanned references included trials. Selection criteria Individually cluster-randomized controlled trials conducted in hypoendemic holoendemic regions including children < 18 years. comparing orally administered with or without folic acid vs. placebo no treatment. fortification was excluded. Antimalarials and/or antiparasitics could be either group. Additional micronutrients only equally both groups. Data collection analysis The primary outcomes were malaria-related events deaths. Secondary haemoglobin, anaemia, other infections, growth, hospitalizations, clinic visits. assessed bias using domain-based evaluation. Two authors independently selected studies extracted data. contacted for missing heterogeneity. performed fixed-effect meta-analysis presented random-effects results when heterogeneity present. present pooled ratios (RR) 95% confidence intervals (CIs). used adjusted analyses trials. Main results Sixty-eight (42,981 children) fulfilled inclusion criteria. did not clinical (RR 1.00, CI 0.88 1.13; 22,724 children, 14 trials, model). similar among who non-anaemic at baseline 0.96, 0.85 1.09). An increased observed that provide surveillance parasitaemia higher 1.13, 1.01 1.26), but there difference adequately concealed trials. + antimalarial protective (four trials). parasitological failure given (three There death across versus 1.11, 0.91 1.36; 21,272 12 significant heterogeneity, endemicity affect this effect. Growth infections mostly affected by supplementation. Authors' conclusions Iron does death, regular treatment services are provided. need screen prior supplementation. Plain Language Summary Iron supplements living malaria-endemic countries Children commonly develop (low haemoglobin) after birth. Anaemia associated several ill-effects, hindering motor development learning skills, it may have an adverse immunity. Babies therefore prevent treat anaemia. In countries where prevalent, suggested increases high dose which as medicine result free circulating blood available parasite, promotes its growth. aimed effects prevalent. randomized compared a medicinal product (and food drink fortification) treatment. Iron disease, indicated fever presence parasites blood. slightly overall, adequate randomization methods. iron-treated children. Although more than 70 identified review, deaths reported 16 11 respectively. haemoglobin about 1 g/dL areas highly At end follow up, varied between two weeks six months supplementation, gain smaller still 0.4 g/dL. respiratory episodes diarrhoea frequent zinc. Children visited medical clinics less placebo, rate hospitalization similar. Weight height adversely rates cure together three examined issue. Our conclusions areas. evidence shown our review limited lack examining relevant information allowing us analyse factors can results, such children's level haemoglobin. Based routine should withheld from