Effect Of Joint Iron And Zinc Supplementation On Malarial Infection And Anaemia

Official URL: http://dx.doi.org/10.1016/S0140-6736(13)60851-X More details/abstract: Background: Future progress in tacking malaria mortality will probably be hampered by the development of resistance to drugs and insecticides and by the contraction of aid budgets. Historically, control was often achieved without malaria specific interventions. Our aim was to assess whether socioeconomic development can contribute to malaria control. Methods: We did a systematic review and meta-analysis to assess whether the risk of malaria in children aged 0-15 years is associated with socioeconomic status. We searched Medline, Web of Science, Embase, the Cochrane Database of Systematic Reviews, the Campbell Library, the Centre for Reviews and Dissemination, Health Systems Evidence, and the Evidence for Policy and Practice Information and Co-ordinating Centre evidence library for studies published in English between Jan 1, 1980, and July 12, 2011, that measured socioeconomic status and parasitologically confirmed malaria or clinical malaria in children. Unadjusted and adjusted effect estimates were combined in fixed effects and random-effects meta-analyses, with a subgroup analysis for different measures of socioeconomic status. We used funnel plots and Egger's linear regression to test for publication bias. Findings: Of 4696 studies reviewed, 20 met the criteria for inclusion in the qualitative analysis, and 15 of these reported the necessary data for inclusion in the meta-analysis. The odds of malaria infection were higher in the poorest children than in the least poor children (unadjusted odds ratio [OR] 1•66, 95% CI 1•35-2•05, p<0•001, I²=68%; adjusted OR 2•06, 1•42-2•97, p<0•001, I²=63%), an effect that was consistent across subgroups. Interpretation: Although we would not recommend discontinuation of existing malaria control efforts, we believe that increased investment in interventions to support socioeconomic development is warranted, since such interventions could prove highly effective and sustainable against malaria in the long term. Version: Accepted Author ManuscriptTerms of use: This work has been licensed by the copyright holder for distribution in electronic format via any medium for the lifetime of the OpenDocs repository for the purpose of free access without charge. NOTICE: this is the author's version of a work that was accepted for publication in The Lancet. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Lancet 382.9896 (2013) SummaryBackground Future progress in tacking malaria mortality will probably be hampered by the development of resistance to drugs and insecticides and by the contraction of aid budgets. Historically, control was often achieved without malariaspecific interventions. Our aim was to assess whether socioeconomic de...

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“…[50][51][52] Malaria and poverty therefore constitute a vicious cycle for the poorest households, exacerbating differences in health and wealth.…”

Section: Asset Ownershipmentioning

confidence: 99%

Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis

et al. 2013

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“…Two small clinical trials have been conducted thus far among pregnant women and have shown no clear evidence of benefit against malaria from either nutrient. 17,18 Both zinc and vitamin A have been examined in relation to pregnancy complications, including preterm birth and reduced fetal growth. Meta-analyses of existing evidence suggest zinc supplementation may moderately reduce preterm birth though neither zinc nor vitamin A supplementation improve fetal growth.…”

Section: Introductionmentioning

confidence: 99%

Vitamin A and Zinc Supplementation Among Pregnant Women to Prevent Placental Malaria: A Randomized, Double-Blind, Placebo-Controlled Trial in Tanzania

Darling

Mugusi

Etheredge

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Vitamin A and zinc are important for immune function and may improve host defense against malaria and reduce the risk of adverse pregnancy outcomes. Our objective was to determine whether daily oral supplementation with either or both nutrients starting in the first trimester reduces the risk of placental malaria and adverse pregnancy outcomes. We undertook a randomized, double-blind placebo-controlled trial with a factorial design among 2,500 human immunodeficiency virus-negative primigravid or secundigravid pregnant women in their first trimester of pregnancy in Dar es Salaam, Tanzania. We randomly allocated equal numbers of participants to 2,500 IU of vitamin A, 25 mg of zinc, both 2,500 IU of vitamin A and 25 mg of zinc, or a placebo until delivery. A total of 625 participants were allocated to each treatment group. Our primary outcome, placental malaria infection (past or current), was assessed in all randomized participants for whom placental samples were obtained at delivery ( = 1,404), which represents 56% of total participants and 62% of all pregnancies lasting 28 weeks or longer ( = 2,266). Birth outcomes were obtained for 2,434 of the 2,500 randomized participants. Secondary outcomes included small for gestational age (SGA) births and prematurity. All analyses were intent to treat. Those who received zinc had a lower risk of histopathology-positive placental malaria compared with those who did not receive zinc (risk ratio = 0.64, 95% confidence interval = 0.44, 0.91), but neither nutrient had an effect on polymerase chain reaction-positive malaria, SGA, or prematurity. No safety concerns were identified. We recommend additional studies in other geographic locations to confirm these findings.

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“…Serum iron (Fe) and zinc (Zn) levels are reduced during infection and inflammation [5] . Manganese (Mn) is an important cofactor for several enzymes that maintain DNA integrity.…”

Section: Introductionmentioning

confidence: 99%

Serum Trace Elements and Heavy Metal Levels in Patients Diagnosed with Chronic Otitis Media and Their Association with Surgical Treatment Outcomes

Bozan¹,

Dinç²,

Demır³

et al. 2017

Int Adv Otol

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OBJECTIVE:To determine the serum iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), magnesium (Mg), cobalt (Co), and lead (Pb) levels in patients with chronic otitis media (COM) and to evaluate the association of the serum levels of these elements with treatment outcomes. MATERIALS and METHODS:Thirty-one healthy volunteers and 31 patients with COM were prospectively included in this study. Serum levels of Fe, Zn, Mn, Mg, Cu, Co, and Pb were determined by an atomic absorption UNICAM-929 spectrophotometer.RESULTS: Serum Co, Pb, and Fe levels were significantly increased (p<0.001) and serum Cu, Zn, Mg, and Mn levels were significantly reduced in patients with COM compared with controls (p<0.001). Serum Co and Mn levels were significantly decreased (p<0.001 and p<0.005, respectively) and serum Cu levels were significantly increased after surgery (p<0.005). The other evaluated blood chemicals and heavy metals did not exhibit significant differences (p>0.05). CONCLUSION:Significant alterations in the serum chemical composition of patients with COM were observed. Moreover, with surgical treatment, serum levels of some of these chemicals were significantly altered. Further prospective studies are warranted to elucidate the exact association of these alterations in the etiopathogenesis of COM.

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Effect Of Joint Iron And Zinc Supplementation On Malarial Infection And Anaemia

Cited by 14 publications

References 27 publications

Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis

Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis

Vitamin A and Zinc Supplementation Among Pregnant Women to Prevent Placental Malaria: A Randomized, Double-Blind, Placebo-Controlled Trial in Tanzania

Serum Trace Elements and Heavy Metal Levels in Patients Diagnosed with Chronic Otitis Media and Their Association with Surgical Treatment Outcomes

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