Cochrane · systematic review · CD006589
Oral iron supplements for children in malaria‐endemic areas
Neuberger, A, Okebe, J, Yahav, D, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
8
No studies
2
Included studies
NR
No studies 2 · 20%Ungraded 0 · 0%Very low 1 · 10%Low 3 · 30%Moderate 1 · 10%High 3 · 30%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyOral iron versus placebo or no treatment for children in malaria‐endemic areas
Population: children in malaria‐endemic areas
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subgroup Oral iron vs placebo or no treatment | no estimate extracted | NR | No studies |
Clinical malaria Oral iron vs placebo or no treatment | RR 0.93 [0.87, 1] | 14 studies · 7168 participants | High |
Clinical malaria Subgrouped by population anaemia (trial level) Oral iron vs placebo or no treatment | RR 0.92 [0.84, 1] | 14 studies · 7168 participants | Moderate Downgraded: inconsistency |
Severe malaria Defined as clinical malaria with high‐grade parasitaemia or requiring admission Oral iron vs placebo or no treatment | RR 0.9 [0.81, 0.98] | 6 studies · 3421 participants | High |
Death Oral iron vs placebo or no treatment | no estimate extracted | 18 studies · 7576 participants | Low Downgraded: imprecision, publication bias |
Hospitalization plus clinic visits Oral iron vs placebo or no treatment | RR 0.99 [0.95, 1.04] | 6 studies · 12578 participants | Very low Downgraded: inconsistency, indirectness |
Effects of oral iron with or without folic acid on malaria among children in malaria‐endemic areas
Population: children in malaria‐endemic areas
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Subgroup | no estimate extracted | NR | No studies |
Clinical malaria Subgrouped by presence of malaria prevention or management services | RR 0.91 [0.84, 0.97] | 7 studies · 5586 participants | Low Downgraded: inconsistency, publication bias |
Oral iron with antimalarial prophylaxis versus placebo or no treatment for children in malaria‐endemic areas
Population: children with or without anaemia at baseline
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical malaria Oral iron with antimalarial prophylaxis vs placebo or no treatment | RR 0.54 [0.43, 0.67] | 728 participants | High |
All‐cause mortality Oral iron with antimalarial prophylaxis vs placebo or no treatment | RR 1.05 [0.52, 2.11] | 728 participants | Low Downgraded: imprecision |
Oral iron supplements for children in malaria endemic areas
Population: children with or without anaemia at baseline
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical malaria Fever (usually >37.5) with parasitaemia | RR 0.99 [0.9, 1.09] | 13 studies · 3851 participants | High |
Clinical malaria among children without anaemia at baseline Fever (usually >37.5) with parasitaemia | RR 0.97 [0.86, 1.09] | 4 studies · 1621 participants | High |
Clinical malaria among children <2 years fever (usually >37.5) with parasitaemia | RR 0.94 [0.82, 1.09] | 4 studies · 1035 participants | High |
Severe malaria (admission for malaria or fever and high‐grade parasitaemia) Admissions for malaria (one study) or fever (>37.5 usually) with parasitaemia >5000 parasites/μL (2 studies) | RR 0.91 [0.76, 1.08] | 4 studies · 1321 participants | Low |
Parasitaemia at end of treatment Slide count with variable definitions | RR 1.09 [0.98, 1.22] | 8 studies · 2291 participants | Very low Downgraded: risk of bias, indirectness |
All‐cause mortality in malaria hyper / holoendemic areas | no estimate extracted | 13 studies · 3798 participants | Low Downgraded: risk of bias, inconsistency |
Hospital admissions in hyper‐ or holoendemic regions Hospital admissions per child month | RR 0.94 [0.81, 1.09] | 4 studies · 14721 participants | Low Downgraded: risk of bias |
Oral iron with folic acid supplements for children in malaria‐endemic areas
Population: children with or without anaemia at baseline
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Severe malaria (admissions for malaria) Admissions to hospital | no estimate extracted | 2 studies · 17575 participants | Low |
Severe malaria (cerebral malaria) Admissions to hospital | no estimate extracted | 2 studies · 1619 participants | Moderate |
All‐cause mortality in hyper / holoendemic regions | no estimate extracted | 4 studies · 17898 participants | Moderate Downgraded: risk of bias |
Hospital admissions in hyper / holoendemic regions Hospital admissions per child‐month | RR 1.08 [0.96, 1.22] | 1 study · 191472 participants | Low |
Oral iron supplements with antimalarial treatment for children in malaria‐endemic areas?
Population: Children with or without anaemia at baseline
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical malaria Fever and parasitaemia | RR 0.54 [0.43, 0.67] | 3 studies · 728 participants | High |
All‐cause mortality | RR 1.05 [0.52, 2.11] | 4 studies · 728 participants | Low Downgraded: risk of bias |
Oral iron supplements in the treatment of malaria
Population: Children with acute malaria and anaemia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Parasitological failure Slide parasite counts | RR 0.98 [0.69, 1.39] | 3 studies · 583 participants | Low Downgraded: risk of bias |
All‐cause mortality | no estimate extracted | 4 studies · 664 participants | Low Downgraded: risk of bias, imprecision |