Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014:2014:625905.
doi: 10.1155/2014/625905. Epub 2014 Jan 19.

Effect of iron/folic Acid supplementation on the outcome of malaria episodes treated with sulfadoxine-pyrimethamine

Sunil Sazawal  1 , Robert E Black  2 , Ibrahim Kabole  3 , Arup Dutta  4 , Usha Dhingra  1 , Mahdi Ramsan  3
Affiliations

Effect of iron/folic Acid supplementation on the outcome of malaria episodes treated with sulfadoxine-pyrimethamine

Sunil Sazawal et al. Malar Res Treat. 2014.

Abstract

Folic acid supplementation may potentially alter the efficacy of sulfadoxine-pyrimethamine (SP) treatment in children with malaria. However, there is lack of evidence from randomized controlled trials and effects of folic acid supplementation on clinical efficacy of SP therapy remain moderately understood among children. In a double masked, placebo-controlled trial among preschool children in Pemba Island (Tanzania), iron and folic acid supplementation (Fe/FA) showed an increased risk of hospitalizations and death. In the present paper, we evaluated if folic acid supplementation reduced the efficacy of malaria treatment and thereby contributed to observed adverse effects. During the study, 1648 children had confirmed malarial episodes and received either sulphadoxine-pyrimethamine (SP) treatment and iron folic acid or SP treatment and placebo. These children were evaluated for recovery and incidence of hospitalization during the next 15, 30, and 140 days. Two groups did not differ in malarial episode or hospitalization rate on subsequent 15, 30, and 140 days. Altered efficacy of SP by folic acid was not observed and did not contribute to adverse events in the previous trial. This trial is registered with Controlled-trials.com ISRCTN59549825.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study participants flow diagram.
See this image and copyright information in PMC

References

    1. Hyde JE. Exploring the folate pathway in Plasmodium falciparum . Acta Tropica. 2005;94(3):191–206. - PMC - PubMed
    1. Stoltzfus RJ, Dreyfuss ML. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. International Nutritional Anemia Consultative Group (INACG), World Health Organization (WHO), United Nations Childrens Fund (UNICEF); 1998; ILSI Press; pp. 1–39.
    1. Sazawal S, Black RE, Ramsan M, et al. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. The Lancet. 2006;367(9505):133–143. - PubMed
    1. Carter JY, Loolpapit MP, Lema OE, Tome JL, Nagelkerke NJD, Watkins WM. Reduction of the efficacy of antifolate antimalarial therapy by folic acid supplementation. The American Journal of Tropical Medicine and Hygiene. 2005;73(1):166–170. - PubMed
    1. Wang P, Wang Q, Aspinall TV, Sims PFG, Hyde JE. Transfection studies to explore essential folate metabolism and antifolate drug synergy in the human malaria parasite Plasmodium falciparum . Molecular Microbiology. 2004;51(5):1425–1438. - PubMed

LinkOut - more resources