scholarly journals Impact of IgG response to malaria-specific antigens and immunity against malaria in pre-school children in Ghana. A cluster randomized, placebo-controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253544
Author(s):  
Samuel Kofi Tchum ◽  
Samuel Asamoah Sakyi ◽  
Bright Adu ◽  
Fareed Arthur ◽  
Felix Boakye Oppong ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
School Children ◽  
Iron Status ◽  
Malaria Episode ◽  
Iron Fortification ◽  
Micronutrient Powder ◽  
Specific Antigens ◽  
Endemic Areas ◽  
Cluster Randomized ◽  
The Impact

Background Iron fortification and micronutrient initiatives, specifically, vitamin A, and zinc supplementation are the most cost-effective developmental strategies against malnutrition and health emergencies in pre-school children. Iron-deficiency among pre-school children have been documented, however, studies evaluating the impact of immunoglobulin G (IgG) isotype responses among iron-fortified pre-school children in malaria endemic communities has not been assessed. We evaluated the impact of iron fortification on the IgG responses to GLURP R0, GLURP R2 and MSP3 FVO malaria-specific antigens among pre-school children in malaria endemic areas. Methods This community-based, placebo-controlled, double-blinded, cluster-randomized trial study was conducted in Wenchi Municipal and Tain District of Bono Region. The trial was registered at ClinicalTrials.gov-registered trial (Identifier: NCT01001871). Ethical approval was obtained and informed consent were sought from each participant parents/guardian. For the current objective, 871 children aged 6–35 months were screened, from which 435 children received semi-liquid home-made meals mixed with 12.5 mg of iron daily (intervention group), and 436 received micronutrient powder without iron (placebo group) for 5 months. Standardized clinical and epidemiological questionnaires were administered and blood samples taken to measure IgG responses to GLURP R0, GLURP R2 and MSP3 FVO recombinant antigens using the Afro Immunoassay (AIA) protocol. Results Baseline anthropometry, malaria diagnosis, anaemia and iron status, demographic features and dietary intake were identical among the groups (p > 0.05). After the intervention, there was no significant difference in the IgG response against GLUP R0, GLUP R2 and MSP3 FVO between the iron-containing micronutrient and placebo groups (p > 0.05). The iron-containing micronutrient powder group who were iron-sufficient or iron replete had significantly higher IgG response to GLURP R0 and GLURP R2 compared to iron-deficient and iron-deficiency anaemia in the same group (p < 0.05). The IgG responses to all the three malaria specific antigens were low among children without malaria episode but high among those with two and four episodes due to exposure differences. Conclusion Iron fortification did not influence antibody response against endogenous malaria specific antigens among pre-school children in malaria endemic areas, however, IgG response to malaria specific antigens were high among children with sufficient iron status.

scholarly journals Impact of iron fortification on anaemia and iron deficiency among pre-school children living in Rural Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246362
Author(s):  
Samuel Kofi Tchum ◽  
Fareed Kow Arthur ◽  
Bright Adu ◽  
Samuel Asamoah Sakyi ◽  
Latifatu Alhassan Abubakar ◽  
...  
Keyword(s):  
Placebo Group ◽  
Iron Deficiency ◽  
School Children ◽  
Iron Status ◽  
Intervention Group ◽  
Iron Group ◽  
Double Burden ◽  
Micronutrient Powder ◽  
The Impact

Anaemia in young sub-Saharan African children may be due to the double burden of malaria and iron deficiency. Primary analysis of a double-blind, cluster randomized trial of iron containing micronutrient powder supplementation in Ghanaian children aged 6 to 35 months found no difference in malaria risk between intervention and placebo groups. Here, we performed a secondary analysis of the trial data to assess the impact of long-term prophylactic iron fortificant on the risk of iron deficiency and anaemia in trial subjects. This population-based randomized-cluster trial involved 1958 children aged between 6 to 35 months, identified at home and able to eat semi-solid foods. The intervention group (n = 967) received a daily dose containing 12.5 mg elemental iron (as ferrous fumarate), vitamin A (400 μg), ascorbic acid (30 mg) and zinc (5 mg). The placebo group (n = 991) received a similar micronutrient powder but without iron. Micronutrient powder was provided daily to both groups for 5 months. At baseline and endline, health assessment questionnaires were administered and blood samples collected for analysis. The two groups had similar baseline anthropometry, anaemia, iron status, demographic characteristics, and dietary intakes (p > 0.05). Of the 1904 (97.2%) children who remained at the end of the intervention, the intervention group had significantly higher haemoglobin (p = 0.0001) and serum ferritin (p = 0.0002) levels than the placebo group. Soluble transferrin receptor levels were more saturated among children from the iron group compared to non-iron group (p = 0.012). Anaemia status in the iron group improved compared to the placebo group (p = 0.03). Continued long-term routine use of micronutrient powder containing prophylactic iron reduced anaemia, iron deficiency and iron deficiency anaemia among pre-school children living in rural Ghana’s malaria endemic area.

scholarly journals Impact of Iron Fortification on Anaemia and Iron Deficiency among Pre-school Children Living in Rural Ghana

2020 ◽  
Author(s):  
Samuel Kofi Tchum ◽  
Fareed Kow Arthur ◽  
Bright Adu ◽  
Samuel Asamoah Sakyi ◽  
Latifatu Alhassan Abubakar ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
School Children ◽  
Iron Deficiency Anaemia ◽  
Iron Status ◽  
Iron Group ◽  
Deficiency Anaemia ◽  
Rural Ghana ◽  
Micronutrient Powder ◽  
To Receive

Abstract Background Micronutrient interventions, principally vitamin A and zinc supplementation for children, and fortification of foods with iron and iodine, are considered the most cost-effective global development efforts. Multiple micronutrient powder is a mixture of at least iron, zinc and vitamin A used to prevent malnutrition in children and during health emergencies. Micronutrient deficiencies are a universal health burden among young children in developing countries. However, the use of this low cost but sustainable micronutrient powder as an innovative home-fortification approach to control a common nutritional disorder like iron deficiency anaemia among pre-school children living in malaria endemic sub-Saharan Africa is unclear. The aim of our study was to determine the effect of providing long-term continued prophylactic micronutrient powder with iron on the risk of iron deficiency and anaemia among pre-school children living in rural Ghana.Methods This population-based randomized-cluster trial was conducted in the Bono region of Ghana from 3rd April to 6th July 2010. 1958 children were recruited, and 967 randomly assigned to receive prophylactic micronutrient powder with iron and 991 assigned to receive placebo. The trial participants were children aged between 6 to 35 months, identified at home and able to eat semi-solid foods (with or without breast milk). Structured questionnaires were administered, their blood samples were also taken for biochemical analysis. They were randomly assigned to receive daily micronutrient powder without or with iron (12·5 mg) added to complementary meals immediately after enrollment for five months. Each participant also received anti-malaria treated bednet and chemotherapy. Weekly follow up visits were conducted at home or health facility where data on malaria using rapid diagnostic test and hospital admissions were collected. The primary outcome was post supplementation of prophylactic micronutrient powder with iron to mitigate the effects of iron deficiency and anaemia.Results 1958 children were recruited and 967 randomly assigned to receive prophylactic micronutrient powder with iron and 991 assigned to receive placebo. Loss to follow up was 7 % (143), with vital status at 35 months of age reported for 1904 (97.2 %). Anthropometry, anaemia, iron status, demographic characteristics and dietary intakes were similar between the groups at baseline. Baseline haemoglobin level was significantly higher compared to haemoglobin level at endline (p < 0.0001). Though, we recorded an increase in haemoglobin (p = 0.0001) and ferritin (p = 0.0002) levels in the iron group than in the placebo group at the end of the intervention. Soluble transferrin receptor levels were more saturated among children from the iron group compared to placebo group (p = 0.012). Anaemic status in the iron group improved compared to the non-iron group (p = 0.03).Conclusion The risk of childhood morbidity and mortality in rural Ghana is high, mainly due to iron deficiency anaemia. National nutritional policy coupled with the current WHO recommendations are required to support the provision of prophylactic micronutrient powder with iron in order to improve anaemic and iron status among pre-school children in rural Ghana.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01001871. Registered 27th October 2009, http://www. ClinicalTrials.gov/ NCT01001871

Fortification of tempeh with encapsulated iron improves iron status and gut microbiota composition in iron deficiency anemia condition

2018 ◽  
Vol 48 (6) ◽  
pp. 962-972 ◽  
Author(s):  
Rio Jati Kusuma ◽  
Aviria Ermamilia
Keyword(s):  
Iron Deficiency ◽  
Gut Microbiota ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Microbiota Composition ◽  
Iron Fortification ◽  
Iron Matrix ◽  
Content Type ◽  
Gut Microbiota Composition

Purpose Iron deficiency anemia (IDA) is one of the most major micronutrient deficiencies worldwide. Food fortification is one strategy for reducing IDA in the population despite concern regarding the gut pathogenic bacteria overgrowth. The purpose of this study was to evaluate the effect of iron encapsulation in banana peel matrix on iron status and gut microbiota composition in iron deficiency anemia. Design/methodology/approach Anemia was induced in 35 male Sprague Dawley rats of age two weeks by the administration of iron-free diet for two weeks. Rats then randomly divided into control, iron-fortified tempeh (temFe) dose 10 and 20 ppm, iron matrix-fortified tempeh dose 10 and 20 ppm and iron matrix fortified tempeh dose 10 and 20 ppm with probiotic mixture. Blood was drawn at Weeks 2 and 6 for hemoglobin and serum iron analysis. Rats were sacrificed at the end of Week 6, and cecal contents were collected for Lactobacillus, Bifidobacteria and Enterobactericeae analysis. Findings Hemoglobin and serum iron were significantly increased (p < 0.05) in all iron-fortified group with the highest value found in iron matrix dose 20 ppm (10.71 ± 0.15 g/dl and 335.83 ± 2.17 µg/dl, respectively). The cecal Lactobacillus and Bifidobacteria did not differ significantly between groups. Cecal Enterobactericeae was significantly different (p < 0.05) among groups with the lowest level in the temFe-20 (2.65 ± 0.78 log CFU) group. Research limitations/implications The use of commercial inoculum instead of pure Rhizopus oligosporus mold for developing the fortified tempeh may impact the effect of product on cecal gut microbiota composition, as different molds and lactic acid bacteria can grow in tempeh when using commercial inoculum. Social implications In Indonesia, iron fortification is conducted primarily in noodles and flour that limits the impact of iron fortification for reducing IDA in population. Iron fortification in food that was daily consumed by people, that is, tempeh, is potential strategy in reducing IDA in population. Originality/value Tempeh fortification using encapsulated iron improved iron status and gut microbiota composition in iron deficiency anemia.

scholarly journals Is iron status associated with markers of non-communicable disease in Indian children?

2021 ◽  
Author(s):  
Santu Ghosh ◽  
Tinku Thomas ◽  
Anura Kurpad ◽  
Harshpal Singh Sachdev
Keyword(s):  
Scenario Analysis ◽  
Communicable Disease ◽  
Iron Status ◽  
Significant Risk ◽  
Additive Models ◽  
Iron Fortification ◽  
Nutrition Survey ◽  
Indian Children ◽  
Reactive Protein ◽  
The Impact

Abstract BackgroundHigh body iron stores have been associated with risk for non-communicable diseases (NCD) like diabetes (high fasting blood sugar, FBS), hypertension (HTN) or dyslipidaemia (high total cholesterol, TC) in adults, but not in adolescent children. This is relevant to iron supplementation and food iron fortification programs that are directed at Indian children. MethodsThe association of NCD with serum ferritin (SF) was examined using logistic additive models, adjusted for confounders such as age, Body Mass Index, C-Reactive Protein, haemoglobin and sex, in adolescent (10-19 years old) participants of the Indian Comprehensive National Nutrition Survey. The interaction of these associations with wealth and co-existing prediabetes was also examined. A scenario analysis was also done to understand the impact of iron fortification of cereals on the prevalence NCD among adolescents.ResultsThe odds ratio (OR) of high FBS, HTN and TC were 1.05 (95% CI 1.01-1.08), 1.02 (95% CI: 1.001-1.03) and 1.04 (95% CI: 1.01-1.06) respectively for every 10µg/L increase in SF. The odds for high TC increased with co-existing prediabetes. The scenario analysis showed that providing 10 mg of iron/day by fortification could increase the prevalence of high FBS by 2%-14% across states of India. Similar increments in HTN and TC can also be expected.ConclusionsHigh SF is associated with a significant risk for NCD in adolescents, and this is dependent on the wealth class, and on co-existing prediabetes. This should be considered when evaluating the benefits and harms of enhancing iron intake in anaemia prevention programs.

Relationship Between Iron Status and Incidence of Infection in Infancy

PEDIATRICS ◽  
1978 ◽  
Vol 62 (2) ◽  
pp. 246-250
Keyword(s):  
Iron Deficiency ◽  
Human Milk ◽  
Breast Feeding ◽  
Clinical Studies ◽  
Iron Status ◽  
Iron Fortification ◽  
Iron Stores ◽  
Immunologic Properties

At present, there is no evidence to warrant modification of the recent recommendations of the Committee for the prevention of iron deficiency in infancy.1 The benefits of supplementation seem to outweigh the possibility of iron excess during a period of development characterized by marginal iron stores. Except for the first two months of life, iron stores in children are proportionately much lower than in the adult, and iron balance may be more precarious. Unless carefully controlled clinical studies provide evidence to the contrary, iron fortification of formula and foods seems to provide safe and effective methods for maintaining iron stores and preventing iron deficiency18,35 in infancy. The benefits of prolonged breast-feeding are emphasized not only for the prevention of iron deficiency but also because of the nutritional and immunologic properties of human milk.

scholarly journals Associations Between Iron Deficiency Anemia and Wages in India: A Secondary Data Analysis (P22-016-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sanchit Makkar ◽  
Sumedha Minocha ◽  
Kishor Bhat ◽  
Anjaly John ◽  
Sumathi Swaminathan ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Least Square ◽  
Sample Survey ◽  
Deficiency Anemia ◽  
Research Centre ◽  
Iron Fortification ◽  
Percentage Points ◽  
Wide Range ◽  
The Impact

Abstract Objectives Economic analyses add value beyond evidence to the implementation of any policy. The study explored the association between iron deficiency anemia (IDA) and the wages of adult men and women between 15- 49 years in India so that the possible monetary benefits of iron fortification policies could be evaluated. Methods National sample survey organization (NSSO) Employment- Unemployment data was statistically matched with the NSSO Consumer Expenditure data at an individual level for the year 2011–12. The anemia levels (assuming 50% of anemia was due to iron deficiency) was mathematically modelled in response to a wide range of nutrient intakes, including iron intake from heme and non-heme sources along with inhibitors and enhancers in the diet, adjusting for bioavailability, sanitation and menstrual losses in women. A two-stage Heckman selection model was used to establish the association between wages and IDA. In the first stage, a probit model was used to determine labour force participation and in the second stage, an ordinary least square model, corrected for sample selection bias, was used to determine the impact of IDA on wages. Results The presence of IDA resulted in a decline of 15.3 percentage points in wages of regular salaried employed men as compared to those without IDA. Similar patterns was observed for women but the impact of anemia on wages was lower in comparison to men. Among women, a decline of 8.0 percentage points was observed in the wages of regular salaried employed women compared to those without IDA. However, the presence of IDA had no significant impact on the wages of casual labourers. This indicated that there were other random factors that affected the wages of this segment of population. Conclusions There is an association between IDA and wages for a segment of working population. Addressing anemia through iron fortification programs such as the usage of double fortified salt could possibly change living standards of the population through improvement in earnings. Funding Sources International Development Research Centre, Canada; Tata Trusts, India.

scholarly journals Malnutrition in an obese world: Can a dietary intervention improve iron status in pre-school children?

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ellen van der Gaag ◽  
Kim Grootelaar ◽  
Thalia Hummel
Keyword(s):  
Iron Deficiency ◽  
School Children ◽  
Dietary Intervention ◽  
Growth Parameters ◽  
Iron Status ◽  
Controlled Trial ◽  
Intervention Group ◽  
Dietary Advice ◽  
Control Group ◽  
National Guidelines

AbstractIntroduction:In previous studies iron deficiency was present in preschool children in the developed world1. The objective of this randomized controlled trial was to investigate whether iron deficiency was present in pre-school children and to what extend laboratory values could be improved with a nutrient rich diet.Material and Methods:A diet consisting of green vegetables, beef, full-fat milk and butter was developed. This diet comes close to the traditional Dutch diet from a century ago. All food products were in age appropriate portions, according to the national guidelines. Children aged one to four years, who were referred to the paediatrician due to recurrent URTI (without immunologic disorders) were allocated to the intervention or the control group. Both groups were given standard care. The intervention group was also given the dietary advise. All parents were asked to note of daily food intake.Results:No iron deficiency was present in our group of 1–4 years old. Mean Hb was 7.3 mmol/l in both groups. After following the dietary advice for 6 months,the hemoglobulin (Hb) concentration increased in both groups, but a little more in the intervention group :(0,280 mmol/l; p < 0,001 in the dietary intervention group and 0,214 mmol/l in the control group; p = 0,003). MCV values increased in the interventiongroup from 77.9 to 78.8 fl (p = 0.007) whereas a smaller increase was visible in the control group ;78.5 to 78.9 fl (p = 0.18). Ferritin, a marker for iron status but also a marker for inflammation, decreased non-significantly in both groups. There was a significantly correlation with decreasing CRP levels, therefore indicating a decrease in inflammation and not merely representing iron status. Growth parameters (weight, height or BMI) did not change significantly in both groups.Discussion and Conclusion:NoHb deficiency was present in our research population. However, a diet consisting of green vegetables, beef, full-fat milk and butter did improve the iron status in pre-school children. Hb and MCV values increased, suggesting some evidence of subclinical iron deficiency in this group.

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