Estimating the Hidden Burden of Iron Deficiency Among African Children

2019 ◽  
Author(s):  
John Muthii Muriuki ◽  
Alexander J. Mentzer ◽  
Emily Webb ◽  
Alireza Morovat ◽  
Wandia Kimita ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
African Children

scholarly journals Effects of iron intake on neurobehavioural outcomes in African children: a systematic review and meta-analysis of randomised controlled trials

2021 ◽  
Vol 6 ◽  
pp. 181
Author(s):  
Agnes M. Mutua ◽  
Kelvinson Mwangi ◽  
Amina Abubakar ◽  
Sarah H. Atkinson
Keyword(s):  
Systematic Review ◽  
Iron Deficiency ◽  
Developmental Delay ◽  
Randomised Controlled Trials ◽  
Iron Supplementation ◽  
Controlled Trials ◽  
African Countries ◽  
Beneficial Effects ◽  
African Children ◽  
Randomised Controlled

Background: Iron deficiency and developmental delay are common in African children. While experimental studies indicate an important role of iron in brain development, effects of iron on child development remain unclear. We aimed to evaluate the effects of iron supplementation or fortification on neurobehavioural outcomes in African children and further summarise these effects in children living in non-African countries for comparison. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus and Cochrane Library for studies published up to 22nd October 2021. We included randomised controlled trials (RCTs) evaluating effects of iron supplementation or fortification on neurobehavioural outcomes in children. Due to heterogeneity in study methods, we analysed all studies qualitatively and in secondary analyses only seven RCTs with 11 arms were meta-analysed. Results: We identified 2231 studies and included 35 studies (n=9988) in the systematic review. Only five studies (n=1294) included African children while 30 (n=8694) included children living in non-African countries. Of the five African studies, two (n=647) reported beneficial effects of iron supplementation on neurobehavioural outcomes in anaemic children, while three (n=647) found no beneficial effects. Of 30 studies in children living in non-African countries, 10 (n=3105) reported beneficial effects of iron supplementation or fortification on neurobehavioural outcomes, seven (n=786) reported beneficial effects only in children who had iron deficiency, iron deficiency anaemia or anaemia while 13 (n=4803) reported no beneficial effects. Conclusions: There are few studies in African children despite the high burden of iron deficiency and developmental delay in this population. Evidence on the effects of iron supplementation on neurobehavioural outcomes remains unclear and there is need for further well-powered studies evaluating these effects in African populations. PROSPERO registration: CRD42018091278 (20/03/2018)

scholarly journals How Eliminating Malaria May Also Prevent Iron Deficiency in African Children

2018 ◽  
Vol 11 (4) ◽  
pp. 96 ◽  
Author(s):  
John Muriuki ◽  
Sarah Atkinson
Keyword(s):  
Iron Deficiency ◽  
Malaria Infection ◽  
Iron Status ◽  
Causal Link ◽  
Sub Saharan Africa ◽  
African Children ◽  
Sub Saharan ◽  
Factor Α ◽  
Epidemiology Studies ◽  
Necrosis Factor

Malaria and iron deficiency are common among children living in sub-Saharan Africa. Several studies have linked a child’s iron status to their future risk of malaria infection; however, few have examined whether malaria might be a cause of iron deficiency. Approximately a quarter of African children at any one time are infected by malaria and malaria increases hepcidin and tumor necrosis factor-α concentrations leading to poor iron absorption and recycling. In support of a hypothetical link between malaria and iron deficiency, studies indicate that the prevalence of iron deficiency in children increases over a malaria season and decreases when malaria transmission is interrupted. The link between malaria and iron deficiency can be tested through the use of observational studies, randomized controlled trials and genetic epidemiology studies, each of which has its own strengths and limitations. Confirming the existence of a causal link between malaria infection and iron deficiency would readjust priorities for programs to prevent and treat iron deficiency and would demonstrate a further benefit of malaria control.

scholarly journals Respiratory infections drive hepcidin-mediated blockade of iron absorption leading to iron deficiency anemia in African children

2019 ◽  
Vol 5 (3) ◽  
pp. eaav9020 ◽  
Author(s):  
Andrew M. Prentice ◽  
Amat Bah ◽  
Momodou W. Jallow ◽  
Amadou T. Jallow ◽  
Saikou Sanyang ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Absorption ◽  
Respiratory Infections ◽  
Fecal Calprotectin ◽  
Deficiency Anemia ◽  
Low Grade ◽  
Reactive Protein ◽  
African Children ◽  
Low Grade Inflammation

Iron deficiency anemia (IDA) is the most prevalent nutritional condition worldwide. We studied the contribution of hepcidin-mediated iron blockade to IDA in African children. We measured hepcidin and hemoglobin weekly, and hematological, inflammatory, and iron biomarkers at baseline, 7 weeks, and 12 weeks in 407 anemic (hemoglobin < 11 g/dl), otherwise healthy Gambian children (6 to 27 months). Each child maintained remarkably constant hepcidin levels (P < 0.0001 for between-child variance), with half consistently maintaining levels that indicate physiological blockade of iron absorption. Hepcidin was strongly predicted by nurse-ascribed adverse events with dominant signals from respiratory infections and fevers (all P < 0.0001). Diarrhea and fecal calprotectin were not associated with hepcidin. In multivariate analysis, C-reactive protein was the dominant predictor of hepcidin and contributed to iron blockade even at very low levels. We conclude that even low-grade inflammation, especially associated with respiratory infections, contributes to IDA in African children.

scholarly journals Effects of iron intake on neurobehavioural outcomes in African children: a systematic review and meta-analysis of randomised controlled trials

2021 ◽  
Vol 6 ◽  
pp. 181
Author(s):  
Agnes M. Mutua ◽  
Kelvinson Mwangi ◽  
Amina Abubakar ◽  
Sarah H. Atkinson
Keyword(s):  
Systematic Review ◽  
Iron Deficiency ◽  
Randomised Controlled Trials ◽  
Iron Supplementation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
African Countries ◽  
Beneficial Effects ◽  
African Children ◽  
Randomised Controlled

Background: Iron deficiency and developmental delay are common in African children. While experimental studies indicate an important role of iron in brain development, effects of iron on child development remain unclear. We aimed to evaluate the effects of iron supplementation or fortification on neurobehavioural outcomes in African children and further summarise these effects in children living in non-African countries for comparison. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus and Cochrane Library for studies published up to 9th March 2021. We included randomised controlled trials (RCTs) evaluating effects of iron supplementation or fortification on neurobehavioural outcomes in children. Due to heterogeneity in study methods, we analysed the studies qualitatively and only seven RCTs with 11 arms were meta-analysed. Results: We identified 2155 studies and included 34 studies (n=9808) in the systematic review. Only five studies (n=1294) included African children while 29 (n=8514) included children living in non-African countries. Of the five African studies, two (n=647) reported beneficial effects of iron supplementation on neurobehavioural outcomes in anaemic children while three (n=647) found no beneficial effects. Of 29 studies in children living in non-African countries, nine (n=2925) reported beneficial effects of iron supplementation or fortification on neurobehavioural outcomes, seven (n=786) reported beneficial effects only in children who had iron deficiency, iron deficiency anaemia or anaemia while 13 (n=4803) reported no beneficial effects. Meta-analysis of seven studies (n=775) in non-African countries showed no beneficial effects of iron supplementation on cognitive or motor development in children. Conclusions: There are few studies in African children despite the high burden of iron deficiency and developmental delay in this population. Evidence on the effects of iron supplementation on neurobehavioural outcomes remains unclear and there is need for further well-powered studies evaluating these effects in African populations. PROSPERO registration: CRD42018091278 (20/03/2018)

Anaemia in African children: malaria or iron deficiency?

The Lancet ◽  
2003 ◽  
Vol 361 (9376) ◽  
pp. 2249-2250 ◽  
Author(s):  
Hans Verhoef ◽  
Clive E West
Keyword(s):  
Iron Deficiency ◽  
African Children

scholarly journals Combinatorial effects of malaria season, iron deficiency, and inflammation determine plasma hepcidin concentration in African children

Blood ◽  
2014 ◽  
Vol 123 (21) ◽  
pp. 3221-3229 ◽  
Author(s):  
Sarah H. Atkinson ◽  
Andrew E. Armitage ◽  
Shivani Khandwala ◽  
Tabitha W. Mwangi ◽  
Sophie Uyoga ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Iron Therapy ◽  
African Children ◽  
Key Points ◽  
Control Dynamic

Key Points Iron status, erythropoietic drive, inflammation, and malaria season combine to control dynamic fluctuations of hepcidin in African children. At the end of the malaria season, hepcidin is low and ID is more prevalent, so iron therapy may be beneficial at this time.

scholarly journals Estimating the burden of iron deficiency among African children

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
John Muthii Muriuki ◽  
Alexander J. Mentzer ◽  
Emily L. Webb ◽  
Alireza Morovat ◽  
Wandia Kimita ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
African Children

scholarly journals Malaria is a cause of iron deficiency in African children

2021 ◽  
Author(s):  
John Muthii Muriuki ◽  
Alexander J. Mentzer ◽  
Ruth Mitchell ◽  
Emily L. Webb ◽  
Anthony O. Etyang ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
African Children

Hemoquant Determination of Hookworm-Related Blood Loss and Its Role in Iron Deficiency in African Children

1996 ◽  
Vol 55 (4) ◽  
pp. 399-404 ◽  
Author(s):  
Rebecca J. Stoltzfus ◽  
Lorenzo Savioli ◽  
James Tielsch ◽  
Kerry Schulze ◽  
Ray Yip ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
African Children

scholarly journals Vitamin D status is associated with iron status, but not anemia, in African children

2021 ◽  
Author(s):  
Reagan M Mogire ◽  
John Muthii Muriuki ◽  
Alireza Morovat ◽  
Alexander J Mentzer ◽  
Emily L Webb ◽  
...  
Keyword(s):  
Vitamin D ◽  
Iron Deficiency ◽  
Vitamin D Deficiency ◽  
Iron Status ◽  
Sub Saharan Africa ◽  
Vitamin D Status ◽  
Regression Analyses ◽  
African Children ◽  
Increased Risk ◽  
African Populations

Background Nutritional deficiencies, including vitamin D and iron deficiency, are prevalent among children living in sub-Saharan Africa. Vitamin D inhibits the transcription of the iron hormone hepcidin thus permitting efficient iron absorption, and iron deficiency alters vitamin D metabolism. Studies have reported associations between vitamin D and iron status, but little is known about their association in African populations. Objective We aimed to evaluate the association between vitamin D and iron status in African children. Methods In this cross-sectional study, we measured biomarkers of iron status, inflammation and 25-hydroxyvitamin D (25(OH)D) levels in 4509 children aged 0.3 months to 8 years from Kenya, Uganda, Burkina Faso, The Gambia and South Africa. We used regression analyses to evaluate the association between vitamin D and iron status. Results Stunting, underweight, inflammation and malaria were highly prevalent. Overall prevalence of iron deficiency was 35.1%, while the prevalence of vitamin D deficiency was 0.6% and 7.8% as defined by 25(OH)D levels of <30 nmol/L and <50 nmol/L respectively. Children with 25(OH)D levels <50 nmol/L had an 80% increased risk of iron deficiency (OR 1.80 [95% CI 1.40, 2.31]) and had lower hepcidin levels than those with 25(OH)D levels >75 nmol/L. 25(OH)D levels were positively associated with ferritin, hepcidin and soluble transferrin receptor levels and negatively associated with serum iron and transferrin saturation in multivariable regression analyses. Vitamin D status was not associated with hemoglobin levels or anemia. Conclusions These findings suggest that vitamin D deficiency may variably influence different iron compartments and measures of iron status in young African children. Additional research is required to confirm these findings and determine direction of causality. The interplay between vitamin D and iron status should be considered in strategies to manage these nutrient deficiencies in African populations.

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