Implications of malaria on iron deficiency control strategies.
The populations in greatest need of iron supplementation are also those at greatest risk of malaria: pregnant women and young children. Iron supplementation has been shown to increase malaria risk in these groups in numerous studies, although this effect is likely diminished by factors such as host immunity, host iron status, and effective malaria surveillance and control. Conversely, the risk of anemia is increased by malaria infections and preventive measures against malaria decrease anemia prevalence in susceptible populations without iron supplementation. Studies have shown that subjects with malaria experience diminished absorption of orally administered iron, so that as a consequence, iron supplementation may have generally reduced efficacy in malarious populations. A possible mechanistic link between malaria, poor absorption of iron, and anemia is provided by recent research on hepcidin, the human iron control hormone. Our improved understanding of iron metabolism may contribute to the control of malaria and the treatment of anemia. Malaria surveillance and control are necessary components of programs to control iron deficiency and may enhance the efficacy of iron supplementation.
Laboratory of Malaria Immunology and Vaccinology, NIAID, National Institutes of Health, Bethesda, MD, USA.
Natasha
N
Spottiswoode
Michal
M
Fried
Hal
H
Drakesmith
Patrick E
PE
Duffy
D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000517:prevention & control*; D023181:Antimicrobial Cationic Peptides / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D019587:Dietary Supplements / Q000009:adverse effects*; D005260:Female; D064451:Hepcidins; D006801:Humans; D007223:Infant; D019266:Iron, Dietary / Q000009:adverse effects*; D008288:Malaria / Q000150:complications; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D012307:Risk Factors
D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D064451:Hepcidins; D019266:Iron, Dietary