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Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
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Risks of routine iron and folic acid supplementation for young children

S Pasricha1, A Shet, H P S Sachdev

  • 1St Johns Research Institute, St Johns National Academy of Health Sciences, Bangalore, India.

Indian Pediatrics
|November 6, 2009
PubMed

Insights

Routine iron-folic acid (IFA) supplementation for young children in India may increase malaria risk. Recommendations are being revised for malaria-endemic areas, balancing anemia treatment with infection prevention.

Area of Science:

  • Pediatric Nutrition
  • Public Health Policy
  • Infectious Disease Epidemiology

Background:

  • Iron-folic acid (IFA) supplementation is recommended for nearly 70% of anemic young children in India.
  • A potential risk associated with routine IFA supplementation is an increased incidence of infectious diseases, particularly malaria.

Purpose of the Study:

  • To review the evidence on iron-folic acid (IFA) supplementation in children under 5.
  • To inform updated recommendations for IFA supplementation policies in India, considering malaria endemicity.

Main Methods:

  • Conducted an extensive literature search across PubMed, WHO, and Indian Government databases.
  • Focused on studies concerning IFA supplementation in children under 5 years of age.

Main Results:

  • Previous reviews indicated potential adverse effects of IFA in malaria-endemic areas.
  • A recent trial in Tanzania showed increased malaria-related mortality with IFA, while a Nepal study found no adverse effects in a non-malarious region.
  • These findings led the World Health Organization to revise IFA supplementation guidelines for malaria-endemic regions.

Conclusions:

  • India exhibits varied malaria endemicity across regions.
  • Routine IFA supplementation should continue in non-malarious areas without modification.
  • In malarious regions, IFA supplementation should be implemented cautiously, contingent upon effective malaria control and functioning primary healthcare infrastructure.
Abstract

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