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Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial

BACKGROUND: The safety of iron supplementation for young women is uncertain in malaria-endemic settings. METHODS: This was a double-blind, randomized controlled noninferiority trial in rural Burkina Faso. RESULTS: A total of 1959 nulliparae were assigned to weekly supplementation (60 mg iron and 2.8...

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Autores principales: Gies, Sabine, Diallo, Salou, Roberts, Stephen A, Kazienga, Adama, Powney, Matthew, Brabin, Loretta, Ouedraogo, Sayouba, Swinkels, Dorine W, Geurts-Moespot, Anneke J, Claeys, Yves, D’Alessandro, Umberto, Tinto, Halidou, Faragher, Brian, Brabin, Bernard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107738/
https://www.ncbi.nlm.nih.gov/pubmed/29733403
http://dx.doi.org/10.1093/infdis/jiy257
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author Gies, Sabine
Diallo, Salou
Roberts, Stephen A
Kazienga, Adama
Powney, Matthew
Brabin, Loretta
Ouedraogo, Sayouba
Swinkels, Dorine W
Geurts-Moespot, Anneke J
Claeys, Yves
D’Alessandro, Umberto
Tinto, Halidou
Faragher, Brian
Brabin, Bernard
author_facet Gies, Sabine
Diallo, Salou
Roberts, Stephen A
Kazienga, Adama
Powney, Matthew
Brabin, Loretta
Ouedraogo, Sayouba
Swinkels, Dorine W
Geurts-Moespot, Anneke J
Claeys, Yves
D’Alessandro, Umberto
Tinto, Halidou
Faragher, Brian
Brabin, Bernard
author_sort Gies, Sabine
collection PubMed
description BACKGROUND: The safety of iron supplementation for young women is uncertain in malaria-endemic settings. METHODS: This was a double-blind, randomized controlled noninferiority trial in rural Burkina Faso. RESULTS: A total of 1959 nulliparae were assigned to weekly supplementation (60 mg iron and 2.8 mg folic acid) (n = 980) or 2.8 mg folic acid (n = 979) until first antenatal visit (ANC1), or 18 months if remaining nonpregnant. Three hundred fifteen women attended ANC1, and 916 remained nonpregnant. There was no difference at ANC1 in parasitemia prevalence (iron, 53.4% [95% confidence interval {CI}, 45.7%–61.0%]; control, 55.3% [95% CI, 47.3%–62.9%]; prevalence ratio, 0.97 [95% CI, .79–1.18]; P = .82), anemia (adjusted effect, 0.96 [95% CI, .83–1.10]; P = .52), iron deficiency (adjusted risk ratio [aRR], 0.84 [95% CI, .46–1.54]; P = .58), or plasma iron biomarkers. Outcomes in nonpregnant women were parasitemia (iron, 42.9% [95% CI, 38.3%–47.5%]; control, 39.2% [95% CI, 34.9%–43.7%]; prevalence ratio, 1.09 [95% CI, .93–1.28]; P = .282); anemia (aRR, 0.90 [95% CI, .78–1.05]; P = .17), and iron deficiency (aRR, 0.99 [95% CI, .77–1.28]; P = .96), with no iron biomarker differences. CONCLUSIONS: Weekly iron supplementation did not increase malaria risk, improve iron status, or reduce anemia in young, mostly adolescent menstruating women, nor in early pregnancy. World Health Organization Guidelines for universal supplementation for young nulliparous women may need reassessment. CLINICAL TRIALS REGISTRATION: NCT01210040.
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spelling pubmed-61077382018-08-30 Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial Gies, Sabine Diallo, Salou Roberts, Stephen A Kazienga, Adama Powney, Matthew Brabin, Loretta Ouedraogo, Sayouba Swinkels, Dorine W Geurts-Moespot, Anneke J Claeys, Yves D’Alessandro, Umberto Tinto, Halidou Faragher, Brian Brabin, Bernard J Infect Dis Major Articles and Brief Reports BACKGROUND: The safety of iron supplementation for young women is uncertain in malaria-endemic settings. METHODS: This was a double-blind, randomized controlled noninferiority trial in rural Burkina Faso. RESULTS: A total of 1959 nulliparae were assigned to weekly supplementation (60 mg iron and 2.8 mg folic acid) (n = 980) or 2.8 mg folic acid (n = 979) until first antenatal visit (ANC1), or 18 months if remaining nonpregnant. Three hundred fifteen women attended ANC1, and 916 remained nonpregnant. There was no difference at ANC1 in parasitemia prevalence (iron, 53.4% [95% confidence interval {CI}, 45.7%–61.0%]; control, 55.3% [95% CI, 47.3%–62.9%]; prevalence ratio, 0.97 [95% CI, .79–1.18]; P = .82), anemia (adjusted effect, 0.96 [95% CI, .83–1.10]; P = .52), iron deficiency (adjusted risk ratio [aRR], 0.84 [95% CI, .46–1.54]; P = .58), or plasma iron biomarkers. Outcomes in nonpregnant women were parasitemia (iron, 42.9% [95% CI, 38.3%–47.5%]; control, 39.2% [95% CI, 34.9%–43.7%]; prevalence ratio, 1.09 [95% CI, .93–1.28]; P = .282); anemia (aRR, 0.90 [95% CI, .78–1.05]; P = .17), and iron deficiency (aRR, 0.99 [95% CI, .77–1.28]; P = .96), with no iron biomarker differences. CONCLUSIONS: Weekly iron supplementation did not increase malaria risk, improve iron status, or reduce anemia in young, mostly adolescent menstruating women, nor in early pregnancy. World Health Organization Guidelines for universal supplementation for young nulliparous women may need reassessment. CLINICAL TRIALS REGISTRATION: NCT01210040. Oxford University Press 2018-10-01 2018-05-04 /pmc/articles/PMC6107738/ /pubmed/29733403 http://dx.doi.org/10.1093/infdis/jiy257 Text en © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Articles and Brief Reports
Gies, Sabine
Diallo, Salou
Roberts, Stephen A
Kazienga, Adama
Powney, Matthew
Brabin, Loretta
Ouedraogo, Sayouba
Swinkels, Dorine W
Geurts-Moespot, Anneke J
Claeys, Yves
D’Alessandro, Umberto
Tinto, Halidou
Faragher, Brian
Brabin, Bernard
Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title_full Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title_fullStr Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title_full_unstemmed Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title_short Effects of Weekly Iron and Folic Acid Supplements on Malaria Risk in Nulliparous Women in Burkina Faso: A Periconceptional, Double-Blind, Randomized Controlled Noninferiority Trial
title_sort effects of weekly iron and folic acid supplements on malaria risk in nulliparous women in burkina faso: a periconceptional, double-blind, randomized controlled noninferiority trial
topic Major Articles and Brief Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107738/
https://www.ncbi.nlm.nih.gov/pubmed/29733403
http://dx.doi.org/10.1093/infdis/jiy257
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