The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya
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The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya. / Olsen, Annette; Nawiri, J; Friis, Henrik.
In: Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 94, No. 5, 2001, p. 493-499.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya
AU - Olsen, Annette
AU - Nawiri, J
AU - Friis, Henrik
PY - 2001
Y1 - 2001
N2 - A randomized, placebo-controlled, double-blind trial was carried out in 1994-96 among 231 children and 181 adults in order to determine the effects of iron on reinfection rates and intensities of hookworm, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni. Adults given 60 mg elemental iron twice-weekly for 12 months had significantly lower reinfection rates of A. lumbricoides (16.7% vs 31.9%, P = 0.046), T. trichiura (6.9% vs 20.6%, P = 0.03) and S. mansoni (38.3% vs 61.8%, P = 0.008) compared to adults given placebo. In contrast, adults allocated to iron had a significantly higher reinfection rate of hookworm at the 4-month examination (11.1% vs 0%, P = 0.009), but the difference was not significant at 8- and 12-month follow-up examinations. Iron supplementation had no effect on reinfection intensities in adults. Surprisingly, iron supplementation had no effect on either reinfection rates or intensities in children. Multiple logistic regression analyses controlling for baseline infection status confirmed the effect in adults of iron on A. lumbricoides, T. trichiura and S. mansoni reinfection rates. The effect is suggested to be due to reduced risk behaviour, to improved immune function or to unfavourable host gut conditions caused by an increased oxidative stress. In each case, the lack of effect in children remains to be explained. In contrast, iron supplementation apparently was short-lived in favour of hookworm infection, an effect that needs further clarification. The findings suggest that iron supplementation has a role to play in helminth control programmes and that intraluminal factors may contribute to the regulation of some helminth infections.
AB - A randomized, placebo-controlled, double-blind trial was carried out in 1994-96 among 231 children and 181 adults in order to determine the effects of iron on reinfection rates and intensities of hookworm, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni. Adults given 60 mg elemental iron twice-weekly for 12 months had significantly lower reinfection rates of A. lumbricoides (16.7% vs 31.9%, P = 0.046), T. trichiura (6.9% vs 20.6%, P = 0.03) and S. mansoni (38.3% vs 61.8%, P = 0.008) compared to adults given placebo. In contrast, adults allocated to iron had a significantly higher reinfection rate of hookworm at the 4-month examination (11.1% vs 0%, P = 0.009), but the difference was not significant at 8- and 12-month follow-up examinations. Iron supplementation had no effect on reinfection intensities in adults. Surprisingly, iron supplementation had no effect on either reinfection rates or intensities in children. Multiple logistic regression analyses controlling for baseline infection status confirmed the effect in adults of iron on A. lumbricoides, T. trichiura and S. mansoni reinfection rates. The effect is suggested to be due to reduced risk behaviour, to improved immune function or to unfavourable host gut conditions caused by an increased oxidative stress. In each case, the lack of effect in children remains to be explained. In contrast, iron supplementation apparently was short-lived in favour of hookworm infection, an effect that needs further clarification. The findings suggest that iron supplementation has a role to play in helminth control programmes and that intraluminal factors may contribute to the regulation of some helminth infections.
KW - Adolescent
KW - Ascariasis
KW - Child
KW - Child, Preschool
KW - Cohort Studies
KW - Double-Blind Method
KW - Female
KW - Ferritins
KW - Hemoglobins
KW - Humans
KW - Iron
KW - Kenya
KW - Male
KW - Recurrence
KW - Regression Analysis
KW - Schistosomiasis mansoni
KW - Trichuriasis
U2 - 10.1016/S0035-9203(00)90063-4
DO - 10.1016/S0035-9203(00)90063-4
M3 - Journal article
C2 - 11132373
VL - 94
SP - 493
EP - 499
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
SN - 0035-9203
IS - 5
ER -
ID: 119654036