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About SickKids

September 3, 2013

Study finds iron supplementation does not increase malaria-risk

Two major health issues facing children in sub-Saharan Africa are malaria and iron deficiency. Malaria is the leading cause of childhood death and iron deficiency is the most prevalent, yet preventable, nutritional deficiency affecting approximately 40 per cent of preschool-age children in Africa.

While independent efforts to address both health issues are ongoing, some studies have suggested that iron deficiency anemia may, in fact, protect against malaria. This research also suggested that iron supplements may increase malaria morbidity and mortality.

As a result, in 2006 the World Health Organization and UNICEF recommended limiting the use of iron supplements among children living in high malaria-burden areas due to the concern of increased malaria risk.

In a new study led by Dr. Stanley Zlotkin at The Hospital for Sick Children (SickKids), researchers found that daily use of a micronutrient powder with iron did not result in increased incidence of malaria among young children.

The study, published in the September 4 issue of JAMA, is the first to assess the effect of daily fortification with powered micronutrients including iron at home on malaria incidence in high malaria-burden areas.

For six months, researchers conducted the study in a rural community in central Ghana with children six to 35 months of age.  Children were divided into two groups, some receiving micronutrient powder with iron and some without.  All children in the study were provided with insecticide-treated bed nets and were treated for malaria or infection as soon as it was detected.  Statistically, there was no difference in the incidence or severity of malaria among the two groups, thus demonstrating that the provision of iron did not increase malaria risk.  

“This research has significant policy implications for countries like Ghana that have not implemented iron supplementation or fortification as part of anemia control programs due to previous recommendations,” says Zlotkin, Principal Investigator of the study and Chief of Global Child Health at SickKids. “I’m hoping that our findings will spark renewed interest and consideration for implementing iron fortification in Ghana as part of the national nutrition policy.”

The micronutrient powder used in this study was invented by Zlotkin in 1996 and is currently being used in over 30 countries.

This study was supported by The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development in partnership with the Bill and Melinda Gates Foundation and the NIH Office of Dietary Supplements.