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January 2000, Volume 54, Number 1, Pages 29-35
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Original Communication
Effect of daily iron supplementation on iron status, cell-mediated immunity, and incidence of infections in 6-36 month old Togolese children
J Berger1, J L Dyck, P Galan2, A Aplogan1, D Schneider1, P Traissac1 and S Hercberg2

1IRD (Institut de Recherche pour le Développement), Nutrition Unit, 911 Avenue Agropolis, BP 5045, 34032 Montpellier Cedex, France

2Centre National des Arts et Métiers, Centre de Recherche sur les Anémies Nutritionnelles, Paris, France

Correspondence to: J Berger, IRD, Service Culturel, Ambassade de France, 57 Tran Hung Dao, Hanoi, Vietnam.

JL Dyck died in February 1999.

Guarantor: Dr Jacques Berger, IRD, Servic Culturel, Ambassade de France, 57 Tran Hung Dao, Hanoi, Viêt Nam Tél: 84-4-971 48 26, Fax: 84-4-971 78 85, j.berger@fpt.vn

Contributors: Jacques Berger, Jean Luc Dyck, Pilar Galan, Serge Hercberg and Dominique Schneider participated to the study design. Jacques Berger and Jean Luc Dyck had primary responsibility for implementation, personnel supervision and data collection and entry. Biological and biochemical analysis were carried out by Jacques Berger, Dominique Schneider, Jean Luc Dyck and Pilar Galan. Aristide Aplogan was in charge with the medical management of subjects and collection of morbidity data. Jacques Berger and Pierre Traissac carried out the data analysis.

The paper was written by Jacques Berger with contributions of Pilar Galan and Serge Hercberg.

Abstract

Objective: To assess the impact of a daily oral iron supplementation on hematological status, cell-mediated immunity and susceptibility to infections in children living in an environment where iron deficiency, malaria and other infections are frequent.

Design: Randomized, double-blind iron supplementation including a placebo group.

Setting: A village in Togo, West Africa.

Subjects: Of the 229 6-36-month-old children of both sexes recruited, 197 with hemoglobin concentration 80 g/l were included and 163 completed the study.

Intervention: Children received daily a placebo (n=79) or a dose of 2-3 mg of elemental iron per kg of body weight (n=84) for 3 months. Hematological, nutritional and immune status were assessed at the beginning and at the end of the supplementation period, and 6 months later. Morbidity was recorded throughout the study.

Results: Iron supplementation had a significant and positive effect on iron status of children and no impact on the incidence of infections, especially malaria. Its probable effect on immune status was masked by interference of infections and their treatment, which contributed to improve hematological and immune status in both groups.

Conclusion: According to the negative consequences of anemia and iron deficiency on global child development, control of iron deficiency by oral iron supplementation in young children has to be conducted, associated with prophylaxis and treatment of malaria and repeated deworming.

Sponsorship: Program supported by IRD.

European Journal of Clinical Nutrition (2000) 54, 29-35

Keywords

anemia; iron deficiency; iron supplementation; cell-mediated immunity; infection; malaria; children; developing country; Africa

Received 20 March 1999; revised 13 July 1999; accepted 16 July 1999
January 2000, Volume 54, Number 1, Pages 29-35
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