Daily iron supplementation in children 24–59 months of age in malaria-endemic areas

Approximately 300 million children globally had anaemia in 2011. The most common cause of anaemia is thought to be deficiency in iron, an essential nutrient for development and cell growth in the immune and neural systems, as well as in regulation of energy metabolism and exercise. Iron deficiency can result from inadequate intake or absorption of dietary iron, increased need during periods of growth, and blood loss from helminth* infection.

Children are particularly vulnerable to iron deficiency anaemia because of their increased iron requirements in the periods of rapid growth, especially in the first five years of life. Iron deficiency anaemia in children has been linked to increased childhood morbidity and impaired cognitive development and school performance.

Malaria is a leading cause of morbidity and mortality in children in sub-Saharan Africa and is an important contributor to anaemia in other endemic regions, through direct rupture of infected red blood cells, the body’s immune destruction of both parasitized and uninfected red blood cells, and temporary dysfunction of the bone marrow.

Results of some studies in young children have suggested that iron supplementation may increase the risk of malaria and death in children living in malaria-endemic regions. However, recent evidence suggests that iron supplementation does not adversely affect children when regular malaria surveillance and treatment services are provided.

Evidence has shown that daily iron supplementation in children 24-59 months of age is associated with increased ferritin (an indicator of iron stores and a biomarker for iron deficiency) and haemoglobin** levels.

* Helminths are a group of parasites commonly referred to as worms and include schistosomes and soil-transmitted helminths
** Haemoglobin is a molecule that allows red blood cells to transport oxygen throughout the body