Originally published February 9 2006
Zanzibar study finds supplementation guidelines do not take malaria into account
by Mike Adams, the Health Ranger, NaturalNews Editor
Working with 24,000 children from Zanzibar, Dr. Robert Black conducted a study that found iron and folic acid supplementation guidelines should be changed, since the current cover-all policy endangers populations with high malaria rates.
Giving all young children iron and folic acid supplements in a population with high rates of malaria could result in an increased risk of severe illness and death, according to the results of a randomised trial in this week's issue of The Lancet.
International guidelines recommend supplementation with iron and folic acid in children younger than age 2 years in areas with a high prevalence of anaemia.
However, there is concern that this policy might be harmful in areas of high malaria transmission.
To investigate this, Robert Black (Johns Hopkins University, Baltimore, USA) and colleagues randomly assigned over 24, 000 children aged 1-35 months from Pemba, Zanzibar, to receive iron and folic acid, or iron, folic acid and zinc, or placebo.
The iron and folic-acid groups of the trial were stopped early because, during follow-up, the investigators found that those who received iron and folic acid with or without zinc had a 12% higher risk of hospitalisations for severe disease or death than those on placebo.
The research team found that only children whose anaemia was associated with iron deficiency benefited from supplementation with iron and folic acid.
In a parallel trial, also published in The Lancet this week, James Tielsch (Johns Hopkins University, Baltimore, USA), Robert Black and colleagues, randomly assigned over 25, 000 children aged 1-36 months in Nepal--an area of low malaria transmission--to receive iron and folic acid, or iron, folic acid and zinc, or placebo.
They found that daily supplementation with iron and folic acid with or without zinc had no effect on their risk of death.
The authors state that despite the lack of effect, universal supplementation with iron and folic acid might still be warranted for young children in areas with low malaria transmission because of their potential role in motor and cognitive development.
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