Intermittent iron supplementation in preschool and school-age children in malaria-endemic areas

It is estimated that worldwide, 600 million preschool and school-age children are anaemic, and it is assumed that at least half of these cases are attributable to iron deficiency. Children are particularly vulnerable to iron deficiency anaemia because of their increased iron requirements in the periods of rapid growth, especially in the first 5 years of life. Iron deficiency anaemia in children has been linked to increased childhood morbidity and impaired cognitive development and school performance.

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.

Supplementation with iron once, twice or three times per week on non-consecutive days has been proposed as an effective and safe way to increase children's iron intake. These intermittent regimens may lead to fewer side effects than the daily regimen and increase adherence to supplementation.