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Efecto de la suplementación con hierro o múltiples micronutrientes sobre la prevalencia de anemia en niños anémicos pequeños de un área endémica para malaria: ensayo aleatorizado y doble ciego
Author(s) -
Ouédraogo Hermann Z.,
DramaixWilmet Michèle,
Zeba Augustin N.,
Hennart Philippe,
Donnen Philippe
Publication year - 2008
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2008.02138.x
Subject(s) - malaria , medicine , parasitemia , micronutrient , confidence interval , randomized controlled trial , anemia , iron deficiency , gastroenterology , pediatrics , plasmodium falciparum , immunology , pathology
Summary Objective To assess the effect of supplementation with iron or multiple micronutrients (MM) on the prevalence of anaemia in a malaria‐endemic area. Methods A community‐based randomized double‐blind trial was conducted in rural Burkina Faso, including children aged 6–23 months with haemoglobin (Hb) concentrations of 70–109 g/l who were randomized into an iron group (Fe, n = 96), an iron and zinc group (IZ, n = 100) or an MM group (MM, n = 100), 5 days/week for 6 months. All children were provided with insecticide‐treated bednets; those who had a Plasmodium falciparum ( PF ) positive‐smear at baseline and/or at each monthly checking received antimalarial therapy. Results The mean (SD) endpoint Hb concentration was higher in the MM group [113.2 (13.6) g/l] than in the IZ group [106.3 (15.6) g/l] and the Fe group [107.1 (12.9) g/l] ( P = 0.001). Children in the MM group were more likely to recover from anaemia than those in the Fe group [prevalence rate ratios, PRR (95% confidence interval, CI) = 1.62 (1.22–2.15), P < 0.001]. The IZ group did not differ from the Fe group [PRR (95% CI) = 0.94 (0.65–1.35), P = 0.72]. None of the interactions on the effect of supplementation of baseline age (0.13), or baseline height‐for‐age z ‐score ( P = 0.33), or incident PF parasitemia ( P = 0.99), was significant. Conclusion In this malaria‐endemic area, in combination with malaria management, the MM supplement was more efficacious than the Fe supplement and the IZ supplement for reducing anaemia. Further investigation into limiting factors and amounts of micronutrients that would be more efficacious for reducing anaemia is recommended.