Daily iron supplementation in children and adolescents 5–12 years 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 or menstruation in adolescent girls.

Iron deficiency anaemia in children has been linked to increased childhood morbidity and impaired cognitive development and school performance. Children between 5 and 12 years of age are at a critical stage of intellectual development, and optimization of their cognitive performance during this period could have long-lasting benefits.

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 5–12 years of age is associated with a reduced risk of iron deficiency and anaemia.

* Helminths are a group of parasites commonly referred to as worms and include schistosomes and soil-transmitted helminths