DOES IRON THERAPY BENEFIT CHILDREN WITH SEVERE MALARIA-ASSOCIATED ANEMIA - A CLINICAL-TRIAL WITH 12 WEEKS SUPPLEMENTATION OF ORAL IRON IN YOUNG-CHILDREN FROM THE TURIANI DIVISION, TANZANIA

Oral iron supplementation is often routinely given to children with ma laria-associated anaemia, but its contribution to recovery is controve rsial. A randomized clinical trial, evaluating such routine, was carri ed out among 100 children, who had a haemoglobin of less than or equal to 5 g/dl and a positive blood smear for malaria parasites. All child ren received malaria therapy (chloroquin+fansidar) and were randomly a llocated to two groups, one receiving additional oral iron treatment, the other being the control. In the 12-week follow-up period the haemo globin level and malaria indices were measured at 2, 4, 8, and 12 week s. There was a 100 per cent compliance during the follow-up period, In each group 20 children (40 per cent) required a blood transfusion. In the remaining 60 children, after 2 weeks the haemoglobin had risen 3. 7 g/dl in the ferrous-supplemented group compared to 3.5 g/dl in the n on-ferrous group, Thereafter, the increase in haemoglobin in both grou ps was steady, At follow-up measurements, the groups did not differ fo r haemoglobin levels, The mean haemoglobin at 12 weeks was 9.2 and 9.0 g/dl, respectively. It was concluded that iron supplementation did no t have any effect on the rate of parasitaemia and on parasite density during the 12 weeks, However, the iron-supplemented group had a signif icantly increased morbidity from other causes than malaria. It appears that iron does not have an effect on the recovery of haemoglobin leve l in children with malaria-associated anaemia. This study provides no evidence supporting routine iron supplementation to these children.