{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:51:39Z","timestamp":1760237499358,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T00:00:00Z","timestamp":1589587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["NIH-1U01HD061234-01A1"],"award-info":[{"award-number":["NIH-1U01HD061234-01A1"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of non-pregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the following rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment. The interim survey was attended by 1223 (82%) of 1486 eligible participants, 1084 (89%) of whom were &lt;20 years at baseline and 242 (22%) were pre-menarcheal. At baseline, prevalence of low body iron stores was 10%. At follow-up, 38% of adolescents had predominantly asymptomatic malaria parasitaemias, with no difference by menarcheal status. Higher body iron stores at baseline predicted an increased malaria risk in the following rainy season (OR 1.18 (95% CI 1.05, 1.34, p = 0.007) after adjusting for bed net use, age, menarche, and body mass index. We conclude that routine iron supplementation should not be recommended without prior effective malaria control.<\/jats:p>","DOI":"10.3390\/nu12051446","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T02:43:42Z","timestamp":1589769822000},"page":"1446","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Iron Status of Burkinab\u00e9 Adolescent Girls Predicts Malaria Risk in the Following Rainy Season"],"prefix":"10.3390","volume":"12","author":[{"given":"Loretta","family":"Brabin","sequence":"first","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care, University of Manchester, Oxford Road, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen A.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Division of Population Health, Health Services Research and Primary Care, University of Manchester, Oxford Road, Manchester M13 9PL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halidou","family":"Tinto","sequence":"additional","affiliation":[{"name":"Clinical Research Unit of Nanoro, (IRSS\u2014URCN), B.P.218 Ouagadougou 11, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Gies","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium and Medical Mission Institute, 97074 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salou","family":"Diallo","sequence":"additional","affiliation":[{"name":"Clinical Research Unit of Nanoro, (IRSS\u2014URCN), B.P.218 Ouagadougou 11, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Brabin","sequence":"additional","affiliation":[{"name":"Liverpool School of Tropical Medicine and Institute of Infection and Global Health, University of Liverpool, Liverpool L7 3EA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,16]]},"reference":[{"key":"ref_1","unstructured":"UNICEF, UNU, and WHO (2001). Iron Deficiency Anaemia. Assessment, Prevention, and Control. A Guide for Programme Managers, NHD."},{"key":"ref_2","unstructured":"World Health Organization (2019). Mainstreaming nutrition through the Life-course. Essential Nutrition Actions, WHO."},{"key":"ref_3","unstructured":"World Health Organization (2020, May 15). Evidence-Based Nutrition Interventions Included in the WHO e-Library of Evidence for Nutrition Actions (eLENA) that may Contribute to the Achievement of the WHO Global Nutrition and Diet-Related NCD Targets. Available online: https:\/\/www.who.int\/elena\/titles\/summary_eLENA_interventions_global_targets.pdf?ua=1."},{"key":"ref_4","first-page":"CD009218","article-title":"Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women","volume":"1","year":"2019","journal-title":"Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pe\u00f1a Rosas, J.P., De-Regil, L.M., Garcia-Casal, M.N., and Dowswell, T. (2015). Daily oral iron supplementation during pregnancy. Syst. Rev., CD004736.","DOI":"10.1002\/14651858.CD004736.pub5"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/nyas.13335","article-title":"Systematic review on evidence-based adolescent nutrition interventions","volume":"1393","author":"Lassi","year":"2017","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Gies, S., Diallo, S., Roberts, S.A., Kazienga, A., Powney, M., Brabin, L., Ouedraogo, S., Swinkels, D.W., Geurts-Moespot, H.J., and Claeys, Y. (2018). Effects of weekly iron and folic acid supplements on malaria risk in nulliparous women in Burkina Faso: A periconceptional double-blind randomized controlled non-inferiority trial. J. Inf. Dis.","DOI":"10.1093\/infdis\/jiy257"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1186\/s12936-018-2509-9","article-title":"Anaemia and malaria","volume":"17","author":"White","year":"2018","journal-title":"Mal. J."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Petry, N., Olofin, I., Hurrell, R.F., Boy, E., Wirth, J.P., Moursi, M., Angel, M.D., and Rohner, F. (2016). The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: A systematic analysis of national surveys. Nutrients, 8.","DOI":"10.3390\/nu8110693"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S524","DOI":"10.1177\/15648265070284S406","article-title":"Iron metabolism and malaria","volume":"28","author":"Prentice","year":"2007","journal-title":"Food. Nutr. Bull."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"875","DOI":"10.3945\/jn.109.118638","article-title":"Is it time to change guidelines for iron supplementation in malarial areas?","volume":"4","author":"Suchdev","year":"2010","journal-title":"J. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0140-6736(13)60437-7","article-title":"Effect of provision of daily zinc and iron with several micronutrients on growth and morbidity among young children in Pakistan: A cluster-randomised trial","volume":"382","author":"Soofi","year":"2013","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Brabin, L., Roberts, S.A., Gies, S., Diallo, S., Stewart, C.L., Kazienga, A., Birtles, J., Ouedraogo, S., Claeys, Y., and Tinto, H. (2017). Effects of long-term weekly iron and folic acid supplementation on lower genital tract infection\u2014A double blind, randomized controlled trial in Burkina Faso. BMC Med., 15.","DOI":"10.1186\/s12916-017-0967-5"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.3945\/jn.117.250381","article-title":"High iron stores in the low malaria season increase malaria risk in the high transmission season in a prospective cohort of rural Zambian children","volume":"147","author":"Barffour","year":"2017","journal-title":"J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.clnu.2019.01.016","article-title":"Malaria early in the first pregnancy: Potential impact of iron status","volume":"39","author":"Diallo","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_16","first-page":"CD006589","article-title":"Oral iron supplementation for preventing or treating anaemia among children in malaria-endemic regions","volume":"3","author":"Ojukwu","year":"2009","journal-title":"Syst. Rev."},{"key":"ref_17","unstructured":"Nutrition International (2020, May 15). Weekly Iron Folic Acid Supplementation (WIFAS). Frequently Asked Questions. Available online: https:\/\/www.nutritionintl.org\/content\/user_files\/2019\/04\/WIFAS_for_Adolescents_FAQs_2019.pdf."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1046\/j.1365-3156.2000.00641.x","article-title":"The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania","volume":"5","author":"Beasley","year":"2000","journal-title":"Trop. Med. Hyg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1177\/156482659902000408","article-title":"Increase in compliance with weekly iron supplementation of adolescent girls by an accompanying communication programme in secondary schools in Dar-Es-Salaam, Tanzania","volume":"20","author":"Muro","year":"1999","journal-title":"Nutr. Bull."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1079\/PHN2001327","article-title":"A randomised trial of the effectiveness of weekly iron supplementation given by teachers on the haemoglobin concentration of schoolchildren","volume":"5","author":"Hall","year":"2001","journal-title":"Public Health Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1038\/sj.ejcn.1602919","article-title":"The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya","volume":"63","author":"Leenstra","year":"2009","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_22","unstructured":"World Health Organization (2017). Global Accelerated Action for the Health of Adolescents (AA-HA). Guidance to Support Country Implementation\u2014Summary, MCA."},{"key":"ref_23","unstructured":"World Health Organization (2018). Weekly Iron and Folic Acid Supplementation as an Anaemia-Prevention Strategy in Women and Adolescent Girls: Lessons Learnt from Implementation of Programmes among Non-Pregnant Women of Reproductive Age, World Health Organization. WHO\/NMH\/NHD\/18.8."},{"key":"ref_24","unstructured":"World Health Organization (2019). World Malaria Report 2019, World Health Organization."},{"key":"ref_25","unstructured":"Institut National de la Statistique et de la D\u00e9mographie (INSD) et ICF International (2012). Enqu\u00eate D\u00e9mographique et de Sant\u00e9 et Indicateurs Multiples du Burkina Faso 2010, INSD et ICF International."},{"key":"ref_26","unstructured":"World Health Organization (2016). Guideline: Daily Iron Supplementation in Adult Women and Adolescent Girls, World Health Organization."},{"key":"ref_27","unstructured":"World Health Organization (2009). Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 1. (2008), World Health Organization."},{"key":"ref_28","first-page":"661","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"Onyango","year":"2007","journal-title":"Bull. WHO"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1373\/clinchem.2010.149187","article-title":"Immunochemical and mass spectrometry-based serum hepcidin assays for a variety of iron metabolism disorders","volume":"56","author":"Kroot","year":"2010","journal-title":"Clin. Chem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3359","DOI":"10.1182\/blood-2002-10-3071","article-title":"The quantitative assessment of body iron","volume":"101","author":"Cook","year":"2003","journal-title":"Blood"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"359S","DOI":"10.3945\/ajcn.116.141762","article-title":"Adjusting ferritin concentrations for inflammation: Biomarkers reflecting inflammation and nutritional determinants of anemia (BRINDA) project","volume":"106","author":"Namaste","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"383S","DOI":"10.3945\/ajcn.116.142307","article-title":"Adjusting total body iron for inflammation: Biomarkers reflecting inflammation and nutritional determinants of anemia (BRINDA) project","volume":"106","author":"Mei","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"372S","DOI":"10.3945\/ajcn.116.142232","article-title":"Adjusting soluble transferrin receptor concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project","volume":"106","author":"Rohner","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1136\/jcp.2009.066498","article-title":"New cut-off values for ferritin and soluble transferrin receptor for the assessment of iron deficiency in children in a high infection pressure area","volume":"62","author":"Phiri","year":"2009","journal-title":"J. Clin. Pathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e218","DOI":"10.1182\/blood-2011-02-337907","article-title":"Serum hepcidin: Reference ranges and biochemical correlates in the general population","volume":"117","author":"Galesloot","year":"2011","journal-title":"Blood"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Fowkes, F.J.I., Davidson, E., Agius, P.A., and Beeson, J.G. (2019). Understanding the interactions between iron supplementation, infectious diseases and adverse birth outcomes is essential to guide public health recommendations. BMC Med., 17.","DOI":"10.1186\/s12916-019-1376-8"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/S1473-3099(06)70655-7","article-title":"Malaria in adolescence: Burden of disease, consequences, and opportunities for intervention","volume":"6","author":"Lalloo","year":"2006","journal-title":"Lancet Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"010411","DOI":"10.7189\/jogh.08.010411","article-title":"Quantifying bias in measuring insecticide-treated bed net use: Meta-analysis of self-reported vs objectively measured adherence","volume":"8","author":"Krezanoski","year":"2018","journal-title":"J. Glob. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s12936-019-3013-6","article-title":"Testing an infection model to explain excess risk of preterm birth with long-term iron supplementation in a malaria endemic are","volume":"18","author":"Brabin","year":"2019","journal-title":"Mal. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e001666","DOI":"10.1136\/bmjgh-2019-001666","article-title":"Impact of school-based malaria case management on school attendance, health and education outcomes: A cluster randomised trial in southern Malawi","volume":"5","author":"Halliday","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e000182","DOI":"10.1136\/bmjgh-2016-000182","article-title":"Impact of a malaria intervention package in schools on Plasmodium infection, anaemia and cognitive function in schoolchildren in Mali: A pragmatic cluster-randomised trial","volume":"2","author":"Clarke","year":"2017","journal-title":"BMJ Glob. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12978-018-0490-y","article-title":"Community approval required for periconceptional adolescent adherence to weekly iron and\/or folic acid supplementation: A qualitative study in rural Burkina Faso","volume":"15","author":"Gies","year":"2018","journal-title":"Rep. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1186\/s12936-017-2123-2","article-title":"Host age and Plasmodium falciparum multiclonality are associated with gametocyte prevalence: A 1-year prospective cohort study","volume":"16","author":"Chenoweth","year":"2017","journal-title":"Mal. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/1475-2875-9-281","article-title":"The plasticity of Plasmodium falciparum gametocytaemia in relation to age in Burkina Faso","volume":"9","author":"Bousema","year":"2010","journal-title":"Mal. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/jisesa\/iev049","article-title":"Characterization of Anopheles gambiae (African Malaria Mosquito) ferritin and the effect of iron on intracellular localization in mosquito cells","volume":"15","author":"Geiser","year":"2015","journal-title":"J. Insect. Sci."},{"key":"ref_46","unstructured":"World Health Organization (2020). WHO Guidelines on Use of Ferritin Concentrations to Assess. Iron Status in Individuals and Populations, World Health Organization."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"570","DOI":"10.3945\/an.111.000885","article-title":"Iron and malaria interactions: Programmatic ways forward","volume":"3","author":"Stoltzfus","year":"2012","journal-title":"Adv. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1446\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:29:35Z","timestamp":1760174975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,16]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["nu12051446"],"URL":"https:\/\/doi.org\/10.3390\/nu12051446","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2020,5,16]]}}}