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Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency
BACKGROUND: Malaria and iron deficiency (ID) in childhood are both associated with cognitive and behavioral dysfunction. The current standard of care for children with malaria and ID is concurrent antimalarial and iron therapy. Delaying iron therapy until inflammation subsides could increase iron ab...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483848/ https://www.ncbi.nlm.nih.gov/pubmed/32403115 http://dx.doi.org/10.1038/s41390-020-0957-8 |
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author | Ssemata, Andrew S. Hickson, Meredith Ssenkusu, John M. Cusick, Sarah E. Nakasujja, Noeline Opoka, Robert O. Kroupina, Maria Georgieff, Michael K. Bangirana, Paul John, Chandy C. |
author_facet | Ssemata, Andrew S. Hickson, Meredith Ssenkusu, John M. Cusick, Sarah E. Nakasujja, Noeline Opoka, Robert O. Kroupina, Maria Georgieff, Michael K. Bangirana, Paul John, Chandy C. |
author_sort | Ssemata, Andrew S. |
collection | PubMed |
description | BACKGROUND: Malaria and iron deficiency (ID) in childhood are both associated with cognitive and behavioral dysfunction. The current standard of care for children with malaria and ID is concurrent antimalarial and iron therapy. Delaying iron therapy until inflammation subsides could increase iron absorption but also impair cognition. METHODS: In this study, Ugandan children 18 months to 5 years old with cerebral malaria (CM, n=79), severe malarial anemia (SMA, n=77) or community children (CC, n=83) were enrolled and tested for ID. Children with ID were randomized to immediate vs. 28-day delayed iron therapy. Cognitive and neurobehavioral outcomes were assessed at baseline and 6 and 12 months (primary endpoint) after enrollment. RESULTS: All children with CM or SMA and 35 CC had ID (zinc protoporphyrin concentration ≥80 μmol/mol heme). No significant differences were seen at 12-month follow-up in overall cognitive ability, attention, associative memory, or behavioral outcomes between immediate and delayed iron treatment (mean difference (standard error of mean) ranged from −0.2 (0.39) to 0.98 (0.5), all P≥0.06). CONCLUSION: Children with CM or SMA and ID who received immediate vs. delayed iron therapy had similar cognitive and neurobehavioral outcomes at 12-month follow-up. |
format | Online Article Text |
id | pubmed-7483848 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
record_format | MEDLINE/PubMed |
spelling | pubmed-74838482020-11-13 Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency Ssemata, Andrew S. Hickson, Meredith Ssenkusu, John M. Cusick, Sarah E. Nakasujja, Noeline Opoka, Robert O. Kroupina, Maria Georgieff, Michael K. Bangirana, Paul John, Chandy C. Pediatr Res Article BACKGROUND: Malaria and iron deficiency (ID) in childhood are both associated with cognitive and behavioral dysfunction. The current standard of care for children with malaria and ID is concurrent antimalarial and iron therapy. Delaying iron therapy until inflammation subsides could increase iron absorption but also impair cognition. METHODS: In this study, Ugandan children 18 months to 5 years old with cerebral malaria (CM, n=79), severe malarial anemia (SMA, n=77) or community children (CC, n=83) were enrolled and tested for ID. Children with ID were randomized to immediate vs. 28-day delayed iron therapy. Cognitive and neurobehavioral outcomes were assessed at baseline and 6 and 12 months (primary endpoint) after enrollment. RESULTS: All children with CM or SMA and 35 CC had ID (zinc protoporphyrin concentration ≥80 μmol/mol heme). No significant differences were seen at 12-month follow-up in overall cognitive ability, attention, associative memory, or behavioral outcomes between immediate and delayed iron treatment (mean difference (standard error of mean) ranged from −0.2 (0.39) to 0.98 (0.5), all P≥0.06). CONCLUSION: Children with CM or SMA and ID who received immediate vs. delayed iron therapy had similar cognitive and neurobehavioral outcomes at 12-month follow-up. 2020-05-13 2020-09 /pmc/articles/PMC7483848/ /pubmed/32403115 http://dx.doi.org/10.1038/s41390-020-0957-8 Text en http://www.nature.com/authors/editorial_policies/license.html#terms Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Ssemata, Andrew S. Hickson, Meredith Ssenkusu, John M. Cusick, Sarah E. Nakasujja, Noeline Opoka, Robert O. Kroupina, Maria Georgieff, Michael K. Bangirana, Paul John, Chandy C. Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title | Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title_full | Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title_fullStr | Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title_full_unstemmed | Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title_short | Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
title_sort | delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483848/ https://www.ncbi.nlm.nih.gov/pubmed/32403115 http://dx.doi.org/10.1038/s41390-020-0957-8 |
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