Haematological response to iron supplementation is reduced in children with asymptomatic Helicobacter pylori infection.
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.
Mahalanabis
Dilip
D
Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata, India. dmahalanabis@vsnl.com
Islam
M Aminul
MA
Shaikh
Saijuddin
S
Chakrabarty
Monilal
M
Kurpad
Anura V
AV
Mukherjee
Swagata
S
Sen
Bandana
B
Khaled
M Abu
MA
Vermund
Sten H
SH
Varmund
Sten H
SH
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
D005296:Ferrous Compounds; D006454:Hemoglobins; D014815:Vitamins; D014801:Vitamin A; D005293:Ferritins; D007501:Iron; C031621:ferrous fumarate