title: Haematological response to iron supplementation is reduced in children with asymptomatic Helicobacter pylori infection.
abstract: We evaluated the adverse effect of asymptomatic Helicobacter pylori infection in children on the response to Fe supplementation. One hundred and sixty-nine children aged 1-10 years from the urban poor community underwent a [13C]urea breath test for H. pylori and haematological tests at admission and after 8 weeks. Both H. pylori-positive and -negative children were randomly assigned to receive ferrous fumarate syrup (20 mg elemental Fe twice daily) or placebo for 8 weeks and a single dose of vitamin A (33,000 microg). Admission findings were compared between H. pylori-positive and -negative children. Response to Fe was compared between Fe-supplemented H. pylori-positive and -negative children. Seventy-nine per cent of the children were aged 1-5 years and half of them were boys. In eighty-five H. pylori-positive and eighty-four H. pylori-negative children, the differences in mean Hb (112 (sd 12.6) v. 113 (sd 12.0) g/l), haematocrit (34 (sd 3.5) v. 35 (sd 3.2) %) and ferritin (23.8 v. 21.0 microg/l) were similar. After 8 weeks of Fe supplementation, mean Hb was 5.3 g/l more (95 % CI 1.59, 9.0) and haematocrit was 1.4 % more (95 % CI 0.2, 2.6) in H. pylori-negative (n 44) compared with H. pylori-positive (n 42) children. Mean ferritin was similar at admission and improved in both H. pylori-positive and -negative children. Asymptomatic H. pylori infection was not associated with higher rates of anaemia or Fe deficiency in children, but had a significant adverse effect on response to Fe therapy. However, this result is based on exploratory analysis and needs confirmation.
authors.affiliation: Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata, India. dmahalanabis@vsnl.com
authors.forename: Dilip
authors.initials: D
authors.lastname: Mahalanabis
authors.forename: M Aminul
authors.initials: MA
authors.lastname: Islam
authors.forename: Saijuddin
authors.initials: S
authors.lastname: Shaikh
authors.forename: Monilal
authors.initials: M
authors.lastname: Chakrabarty
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.forename: Swagata
authors.initials: S
authors.lastname: Mukherjee
authors.forename: Bandana
authors.initials: B
authors.lastname: Sen
authors.forename: M Abu
authors.initials: MA
authors.lastname: Khaled
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.forename: Sten H
authors.initials: SH
authors.lastname: Varmund
mesh_terms: D000740:Anemia / Q000097:blood; D002648:Child; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000008:administration & dosage*; D016481:Helicobacter Infections / Q000097:blood / Q000503:physiopathology*; D016480:Helicobacter pylori; D006400:Hematocrit / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood; D008297:Male; D014801:Vitamin A / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D005296:Ferrous Compounds; D006454:Hemoglobins; D014815:Vitamins; D014801:Vitamin A; D005293:Ferritins; D007501:Iron; C031621:ferrous fumarate