Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2020
Materias:
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
_version_ 1783580964687970304
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
work_keys_str_mv AT ssemataandrews delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT hicksonmeredith delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT ssenkusujohnm delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT cusicksarahe delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT nakasujjanoeline delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT opokaroberto delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT kroupinamaria delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT georgieffmichaelk delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT bangiranapaul delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency
AT johnchandyc delayedirondoesnotaltercognitionorbehavioramongchildrenwithseveremalariaandirondeficiency