In sub-Saharan Africa, malaria is a major cause of childhood death and illness. Children in this region are also at risk for iron deficiency, which can impair the development of the brain and the muscles. For children with iron deficiency, iron-fortified foods and iron supplements can enhance development and prevent severe anemia. However, research had suggested that, in areas where malaria is common, providing iron supplements could also increase the risk of malaria in young children.
In 2006, the World Health Organization and the United Nations Children’s Fund recommended limiting use of iron supplements among children in areas where malaria is common. This recommendation was modified in 2011; iron fortified foods were recommended, but in conjunction with measures to prevent and treat malaria.
Researchers supported by the Pediatric Growth and Nutrition Branch conducted a randomized controlled trial to determine whether providing powdered nutritional supplements that included iron would increase the risk of malaria. The study was conducted among children living in a high malaria-burden area in central Ghana, West Africa. One group of children received powdered nutritional supplements that included iron, and another group received similar supplements that did not include iron. For all children in the study, insecticide-treated bed nets were provided at enrollment, as well as malaria treatment when indicated.
The scientists found no significant difference in the rates of malaria between the no-iron group and the group whose supplements contained iron. The results suggest that iron supplementation should be reconsidered to prevent anemia among children in areas where malaria is common (PMID: 24002280).