Changes in retinol, hemoglobin and ferritin concentrations in Colombian children with malaria
Keywords:
malaria, vitamin A, anemia, child, Colombia
Abstract
Introduction. Malaria, anemia and intestinal parasitism can co-exist in certain populations of Colombian children. The effects of retinol supplementation and anti-intestinal parasite treatment in children with malaria is unknown. Changes after this treatment of with respect to hemoglobin, retinol, ferritin and C reactive protein levels have not been previously monitored.Objective. The effect of simultaneous intervention with antimalarial, retinol supplementation and anti-intestinal parasites treatment will be monitored by examining levels of hemoglobin, ferritin, retinol and C reactive protein in children with malaria.
Materials and methods. A non-blind experimental study was conducted in 93 children with malaria, aged 4-10 years. Each was randomly allocated to one of the following groups: (1) treatment with antimalarial and retinol supplement (Group MA); (2) treatment with antimalarial-retinol supplement and anti-parasitic drug (Group MAP); (3) treatment with antimalarial and anti-parasitic drug (Group MP), and (4) treatment only with antimalarials (Group M). The groups were observed for 30 days, with haemoglobin, ferritin, retinol and C reactive protein evaluated on days 0, 8 and 30 after treatment.
Results. Mean values for the children at day 0 were as follows: hemoglobin 10.3±1.6 g/dL, retinol 19.1±6.0 μg/dL, C reactive protein 75±63 mg/L and ferritin 213±203 μg/L. On day 30 after treatment, hemoglobin and plasma retinol concentrations increased in 1.4±1.4 g/dL and 11.5±8.1 μg/dL, whereas the C reactive protein and ferritin concentrations decreased to 66±60 mg/L, and 184±203 μg/L, respectively. No statistically significant differences appeared among the groups. On day 8, significant differences between the groups were observed in hemoglobin concentrations Group MAP was higher when compared to other groups.
Conclusion. On day 30, hemoglobin and retinol were high, whereas C reactive protein was low. Simultaneous administration of a retinol supplement and anti-parasite treatment prevented hemoglobin reduction observed on day 8 without changes in other variables.
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References
1. Dirección Seccional de Salud de Antioquia. Eventos de interés en salud pública, Antioquia 2006. Fecha de consulta: 20 de mayo de 2008. www.dssa.gov.co/dowload/archivoseventos_2007/EnotificacionSPVer2006-2.xls
2. Castro L, Nicholls S. Deficiencia de hierro, vitamina A y prevalencia de parasitismo intestinal en población infantil y anemias nutricionales en mujeres en edad fértil de Colombia en 1995-1996. Santafé de Bogotá: Instituto Nacional de Salud; 1998. p. 50-5.
3. Ordóñez LE, Angulo ES. Desnutrición y su relación con parasitismo intestinal en niños de una población de la Amazonia colombiana. Biomédica. 2002;22:486-98.
4. Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 1. Iatreia. 2003;16:299-318.
5. Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 2. Iatreia. 2004;17:354-69.
6. van den Berg H. Vitamin A intake and status. Eur J Clin Nutr. 1996;50(Suppl.3):7-12.
7. WHO/NHD. Iron deficiency anaemia, assessment, prevention, and control a guide for programme managers. Geneva: United Nations Children’s Fund, United Nations University, World Health Organization; 2001. p. 10.
8. Tomkins A. Assessing micronutrient status in the presence of inflammation. J Nutr. 2003;133(Suppl.2):1649-55.
9. Hurt N, Smith T, Teuscher T, Tanner M. Do high levels of C-reactive protein in Tanzanian children indicate malaria morbidity? Clin Diagn Lab Immunol. 1994; 1:437-44.
10. Blair S, Álvarez G, Villa A, Carmona-Fonseca J, Ríos L. Estado nutricional y niveles de inmunoglobulinas y citoquinas en niños con malaria. Anales de Pediatría. 2003;58:418-24.
11. Blair S, Álvarez G, Campuzano G. Relación entre anemia y malaria en una población rural colombiana. Boletín de la Dirección de Malariología y Saneamiento Ambiental. 1997;37:7-12.
12. Echeverri M, Tobón A, Álvarez G, Carmona J, Blair S. Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001. Rev Inst Med Trop Sao Paulo. 2003;45:29-34
13. Persson V, Ahmed F, Gebre-Medhin M, Dreiner T. Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children. Public Health Nutr. 2000;3:83-9.
14. Koski KG, Scott ME. Gastrointestinal nematodes, nutrition and immunity: breaking the negative spiral. Annu Rev Nutr. 2001;21:297-321.
15. World Health Organization. Severe falciparum malaria. Severe and complicated malaria. Trans R Soc Trop Med Hyg. 2000;94(Suppl.1):1-88.
16. Willows ND, Gray-Donal K. Serum retinol is associated with hemoglobin concentration in infants who are not vitamin A deficient. Nutr Res. 2003;23:891-900.
17. Stoltzfus RJ, Albonico M, Chwaya HM, Tielsch JM, Schulze KJ, Savioli L. Effects of the Zanzibar school-based deworming program on iron status of children. Am J Clin Nutr. 1998;68:179-86.
18. Stoltzfus RJ, Chway HM, Montresor A, Tielsch JM, Jape JK, Albonico M, et al. Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly antihelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. J Nutr. 2004;134:348-56.
19. Mwanri L, Worsley A, Ryan P, Masika J. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. J Nutr. 2000;130:2691-6.
20. López F, Schmunis G. Diagnóstico de malaria. Publicación científica 512. Washington, D.C.: OPS-OMS; 1988. p. 143.
21. Rice CP, Trull AK, Berry D, Gorman EG. Development and validation of a particle-enhanced turbidimetric immunoassay for C-reactive protein. J Immunol Methods. 1987;99:205-11.
22. Talwar D, Ha TK, Cooney J, Brownlee C, O’Reilly DS. A routine method for the simultaneous measurement of retinol, alpha-tocopherol and five carotenoids in human plasma by reverse phase HPLC. Clin Chim Acta. 1998;270:85-100.
23. Uscátegui RM, Correa AM. Estado nutricional de niños palúdicos residentes en El Bagre y Turbo, Antioquia, Colombia, 2004-2005. Biomédica. 2007;27:559-70.
24. Botero D, Restrepo M. Parasitosis humanas. Cuarta edición. Medellín: Corporación para Investigaciones Biológicas; 2003. p. 455-63.
25. Blair S, Carmona J, Correa AM. Malaria en niños: relaciones entre nutrición e inmunidad. Rev Panam Salud Pública. 2002;11:5-14.
26. Rosales FJ, Topping JD, Smith JE, Shankar AH, Ross AC. Relation of serum retinol to acute phase proteins and malarial morbidity in Papua, New Guinea, children. Am J Clin Nutr. 2000;71:1582-8.
27. Filteau SM, Willumsen JF, Sullivan K, Simmank K, Gamble M. Use of the retinol-binding protein: transthyretin ratio for assessment of vitamin A status during the acute-phase response. Br J Nutr. 2000;83:513-20.
28. Álvarez MC, Correa JM, Deossa GC, Estrada A, Forero Y, Gómez LF et al. Encuesta Nacional de la Situación Nutricional en Colombia. Bogotá: ICBF, Profamilia, Instituto Nacional de Salud, Universidad de Antioquia, OPS, Panamericana Formas e Impresos; 2005. p. 445.
29. Thurnham DI, McCabe GP, Northrop-Clewes CA, Nestel P. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis. Lancet. 2003;362:2052-8.
30. Rahman MM, Wahed MA, Fuchs GJ, Baqui AH, Álvarez JO. Synergistic effect of zinc and vitamin A on the biochemical indexes of vitamin A nutrition in children. Am J Clin Nutr. 2002;75:92-8.
31. Zimmermann MB, Biebinger R, Rohner F, Dib A, Zeder C, Hurrell RF, et al. Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron. Am J Clin Nutr. 2006;84:580-6.
32. Tanumihardjo SA, Permaesih D, Muhilal. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions. Eur J Clin Nutr. 2004;58:1223-30.
33. Stephensen CB, Gildengorin G. Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2000;72:1170-8.
34. Álvarez MC, Uscátegui RM, López C, Baracaldo CM, Castro L, Noy V. Plasma retinol concentration according to pubertal maturation in school children and adolescents of Medellin, Colombia. Eur J Clin Nutr. 2004;58:456-61.
35. Tanumihardjo SA. Assessing vitamin A status: past, present and future. J Nutr. 2004;134(Suppl.1):290-3.
36. Obonyo CO, Vulule J, Akhwale WS, Grobbee DE. In-hospital morbidity and mortality due to severe malarial anemia in western Kenya. Am J Trop Med Hyg. 2007;77:23-8.
37. Anderson GJ, Darshan D, Wilkins SJ, Frazer DM. Regulation of systemic iron homeostasis: how the body responds to changes in iron demand. Biometals. 2007;20:665-74.
38. Rodríguez-Morales AJ, Sánchez E, Vargas M, Piccolo C, Colina R, Arria M. Anemia and thrombocytopenia in children with Plasmodium vivax malaria. J Trop Pediatr. 2006;52:49-51.
39. Villamor E, Mbise R, Spiegelman D, Ndossi G, Fawzi WW. Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania. Am J Trop Med Hyg. 2000;62:590-7.
40. Roberts DJ, Casals-Pascual C, Weatherall DJ. The clinical and pathophysiological features of malarial anaemia. En: Sullivan J, Krishna S, editors. Malaria: drugs, disease and post-genomic biology. Berlin: Springer-Verlag Berlin Heidelberg; 2005. p. 137-8.
2. Castro L, Nicholls S. Deficiencia de hierro, vitamina A y prevalencia de parasitismo intestinal en población infantil y anemias nutricionales en mujeres en edad fértil de Colombia en 1995-1996. Santafé de Bogotá: Instituto Nacional de Salud; 1998. p. 50-5.
3. Ordóñez LE, Angulo ES. Desnutrición y su relación con parasitismo intestinal en niños de una población de la Amazonia colombiana. Biomédica. 2002;22:486-98.
4. Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 1. Iatreia. 2003;16:299-318.
5. Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 2. Iatreia. 2004;17:354-69.
6. van den Berg H. Vitamin A intake and status. Eur J Clin Nutr. 1996;50(Suppl.3):7-12.
7. WHO/NHD. Iron deficiency anaemia, assessment, prevention, and control a guide for programme managers. Geneva: United Nations Children’s Fund, United Nations University, World Health Organization; 2001. p. 10.
8. Tomkins A. Assessing micronutrient status in the presence of inflammation. J Nutr. 2003;133(Suppl.2):1649-55.
9. Hurt N, Smith T, Teuscher T, Tanner M. Do high levels of C-reactive protein in Tanzanian children indicate malaria morbidity? Clin Diagn Lab Immunol. 1994; 1:437-44.
10. Blair S, Álvarez G, Villa A, Carmona-Fonseca J, Ríos L. Estado nutricional y niveles de inmunoglobulinas y citoquinas en niños con malaria. Anales de Pediatría. 2003;58:418-24.
11. Blair S, Álvarez G, Campuzano G. Relación entre anemia y malaria en una población rural colombiana. Boletín de la Dirección de Malariología y Saneamiento Ambiental. 1997;37:7-12.
12. Echeverri M, Tobón A, Álvarez G, Carmona J, Blair S. Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001. Rev Inst Med Trop Sao Paulo. 2003;45:29-34
13. Persson V, Ahmed F, Gebre-Medhin M, Dreiner T. Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children. Public Health Nutr. 2000;3:83-9.
14. Koski KG, Scott ME. Gastrointestinal nematodes, nutrition and immunity: breaking the negative spiral. Annu Rev Nutr. 2001;21:297-321.
15. World Health Organization. Severe falciparum malaria. Severe and complicated malaria. Trans R Soc Trop Med Hyg. 2000;94(Suppl.1):1-88.
16. Willows ND, Gray-Donal K. Serum retinol is associated with hemoglobin concentration in infants who are not vitamin A deficient. Nutr Res. 2003;23:891-900.
17. Stoltzfus RJ, Albonico M, Chwaya HM, Tielsch JM, Schulze KJ, Savioli L. Effects of the Zanzibar school-based deworming program on iron status of children. Am J Clin Nutr. 1998;68:179-86.
18. Stoltzfus RJ, Chway HM, Montresor A, Tielsch JM, Jape JK, Albonico M, et al. Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly antihelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. J Nutr. 2004;134:348-56.
19. Mwanri L, Worsley A, Ryan P, Masika J. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. J Nutr. 2000;130:2691-6.
20. López F, Schmunis G. Diagnóstico de malaria. Publicación científica 512. Washington, D.C.: OPS-OMS; 1988. p. 143.
21. Rice CP, Trull AK, Berry D, Gorman EG. Development and validation of a particle-enhanced turbidimetric immunoassay for C-reactive protein. J Immunol Methods. 1987;99:205-11.
22. Talwar D, Ha TK, Cooney J, Brownlee C, O’Reilly DS. A routine method for the simultaneous measurement of retinol, alpha-tocopherol and five carotenoids in human plasma by reverse phase HPLC. Clin Chim Acta. 1998;270:85-100.
23. Uscátegui RM, Correa AM. Estado nutricional de niños palúdicos residentes en El Bagre y Turbo, Antioquia, Colombia, 2004-2005. Biomédica. 2007;27:559-70.
24. Botero D, Restrepo M. Parasitosis humanas. Cuarta edición. Medellín: Corporación para Investigaciones Biológicas; 2003. p. 455-63.
25. Blair S, Carmona J, Correa AM. Malaria en niños: relaciones entre nutrición e inmunidad. Rev Panam Salud Pública. 2002;11:5-14.
26. Rosales FJ, Topping JD, Smith JE, Shankar AH, Ross AC. Relation of serum retinol to acute phase proteins and malarial morbidity in Papua, New Guinea, children. Am J Clin Nutr. 2000;71:1582-8.
27. Filteau SM, Willumsen JF, Sullivan K, Simmank K, Gamble M. Use of the retinol-binding protein: transthyretin ratio for assessment of vitamin A status during the acute-phase response. Br J Nutr. 2000;83:513-20.
28. Álvarez MC, Correa JM, Deossa GC, Estrada A, Forero Y, Gómez LF et al. Encuesta Nacional de la Situación Nutricional en Colombia. Bogotá: ICBF, Profamilia, Instituto Nacional de Salud, Universidad de Antioquia, OPS, Panamericana Formas e Impresos; 2005. p. 445.
29. Thurnham DI, McCabe GP, Northrop-Clewes CA, Nestel P. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis. Lancet. 2003;362:2052-8.
30. Rahman MM, Wahed MA, Fuchs GJ, Baqui AH, Álvarez JO. Synergistic effect of zinc and vitamin A on the biochemical indexes of vitamin A nutrition in children. Am J Clin Nutr. 2002;75:92-8.
31. Zimmermann MB, Biebinger R, Rohner F, Dib A, Zeder C, Hurrell RF, et al. Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron. Am J Clin Nutr. 2006;84:580-6.
32. Tanumihardjo SA, Permaesih D, Muhilal. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions. Eur J Clin Nutr. 2004;58:1223-30.
33. Stephensen CB, Gildengorin G. Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2000;72:1170-8.
34. Álvarez MC, Uscátegui RM, López C, Baracaldo CM, Castro L, Noy V. Plasma retinol concentration according to pubertal maturation in school children and adolescents of Medellin, Colombia. Eur J Clin Nutr. 2004;58:456-61.
35. Tanumihardjo SA. Assessing vitamin A status: past, present and future. J Nutr. 2004;134(Suppl.1):290-3.
36. Obonyo CO, Vulule J, Akhwale WS, Grobbee DE. In-hospital morbidity and mortality due to severe malarial anemia in western Kenya. Am J Trop Med Hyg. 2007;77:23-8.
37. Anderson GJ, Darshan D, Wilkins SJ, Frazer DM. Regulation of systemic iron homeostasis: how the body responds to changes in iron demand. Biometals. 2007;20:665-74.
38. Rodríguez-Morales AJ, Sánchez E, Vargas M, Piccolo C, Colina R, Arria M. Anemia and thrombocytopenia in children with Plasmodium vivax malaria. J Trop Pediatr. 2006;52:49-51.
39. Villamor E, Mbise R, Spiegelman D, Ndossi G, Fawzi WW. Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania. Am J Trop Med Hyg. 2000;62:590-7.
40. Roberts DJ, Casals-Pascual C, Weatherall DJ. The clinical and pathophysiological features of malarial anaemia. En: Sullivan J, Krishna S, editors. Malaria: drugs, disease and post-genomic biology. Berlin: Springer-Verlag Berlin Heidelberg; 2005. p. 137-8.
How to Cite
1.
Uscátegui RM, Correa AM, Carmona-Fonseca J. Changes in retinol, hemoglobin and ferritin concentrations in Colombian children with malaria. biomedica [Internet]. 2009 Jun. 1 [cited 2024 May 17];29(2):270-81. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/29
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