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Industrial flour fortification is recommended and implemented in many countries to combat neural tube defects. Dietary folates or folic acid can antagonise the action of antifolate drugs that play a critical role in the prevention and treatment of malaria. Randomised trials have shown that folic acid supplementation increases the rate of treatment failures with sulfadoxine\u2010pyrimethamine. The efficacy of antifolate drugs against <jats:italic>Plasmodium<\/jats:italic> is maximized in the absence of exogenous folic acid, suggesting that there is no safe minimum dose of ingested folic acid. We here review the safety and benefits of interventions to increase folate status in malaria\u2010endemic countries. We conclude that formal cost\u2010benefit analyses are required.<\/jats:p>","DOI":"10.1111\/bjh.14618","type":"journal-article","created":{"date-parts":[[2017,3,29]],"date-time":"2017-03-29T18:26:26Z","timestamp":1490811986000},"page":"905-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Safety and benefits of interventions to increase folate status in malaria\u2010endemic areas"],"prefix":"10.1111","volume":"177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-9689","authenticated-orcid":false,"given":"Hans","family":"Verhoef","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine MRC International Nutrition Group London UK"},{"name":"Nutrition Theme MRC Unit The Gambia  Banjul Gambia"},{"name":"Cell Biology and Immunology Group, &amp; Research Wageningen The Netherlands"},{"name":"Division of Human Nutrition Wageningen University and Research Wageningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacobien","family":"Veenemans","sequence":"additional","affiliation":[{"name":"Laboratory for Microbiology and Immunology Admiral de Ruyter Hospital Goes The Netherlands"},{"name":"Laboratory for Microbiology and Infection Control Amphia Hospital Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-4448","authenticated-orcid":false,"given":"Martin N.","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition Wageningen University and Research Wageningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Prentice","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine MRC International Nutrition Group London UK"},{"name":"Nutrition Theme MRC Unit The Gambia  Banjul 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