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首页> 外文期刊>The Internet Journal of Tropical Medicine >Effects Of Vitamin A And Iron Supplementation On The Treatment Of Malaria In Cameroonian Preschool Children
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Effects Of Vitamin A And Iron Supplementation On The Treatment Of Malaria In Cameroonian Preschool Children

机译：维生素A和铁的补充对喀麦隆学龄前儿童疟疾的治疗作用

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摘要

This study investigated the effect of vitamin A and iron on the treatment of malaria, when they are given as supplements to infected preschool children. In a placebo-controlled supplementation trial, 132 children aged between 6 and 60 months were recruited and divided into 4 groups: the first group received 68mg (6-30 months) or 102mg (30-60 months) iron daily and the second, 30mg (6-12 months) or 60mg (12-60 months) of vitamin A in single dose at the beginning of the treatment. The third group received both vitamin A and iron while the placebo received no supplement. Completed data was obtained on parasitaemia, clinical (weight, vitality) and haematological parameters ( red blood cells, white blood cells and haemoglobin) using WHO (1982) methods, and micronutrients status (serum vitamin A and iron) respectively by spectrofluorimetry and atomic absorption spectrophotometry. From this study, it was observed that about 40.15% of the children suffering of malaria were anaemic (haemoglobin level from 9.02 ± 1.60 to 10.72 ± 1.21 g/dl and red blood cells level less than 3500000/ mm3 among 40.15% of infants recruited). They also had moderate to severe vitamin A deficiency (serum vitamin A between 0.53 ± 0.14 and 0.66 ± 0.24μmol/l). Compared with placebo group, infants receiving supplements improved considerably, for clinical and sub clinical parameters (weight gain from 0.49 ± 1.48 to 0.64 ± 1.97Kg, as against – 0.76 ± 2.17Kg in placebo group), iron status (haemoglobin level varied from 0.63 ± 1.33 to 0.94 ± 1.2.10 g/dl as against – 0.68 ± 0.98 g/l). A significant improvement of vitamin A status was observed within groups receiving vitamin A supplementation (serum level 0.08 ± 0.20 to 0.11 ± 0.17μmol/l), while there was a notable decrease in the non supplemented group (– 0.04 ± 0.05μmol/l within the group that received iron, and – 0.07 ± 0.13μmol/l in the placebo group). The improvement was most important in the group receiving either vitamin A or iron supplements than those who received iron or vitamin A alone. This study showed that vitamin A and iron could remarkably improve the treatment of malaria when they are given as supplements to infected children. Background The malaria infection during the young age is a major public health problem occurring in all tropical and sub-tropical area. In sub-Saharan Africa, 75% of infantile deaths are caused by malaria and children have as from 1.6 to 5.4 infections annually (WHO, 2004). The main reasons of this disaster include the increasingly frequent resistances to anti-malarial drugs aggravated by poverty, the insufficiency of sanitary infrastructure and the very widespread civil instabilities in these regions (Snow, 1999). Facing the wild progress of this illness, researches have increased and followed in various axes as Pharmacology, Haematology, Immunology and Entomology. However, in spite of enormous efforts, it always remains difficult to master the curse. Since some decades, a particular attention is granted to the importance of nutrition in the development of malaria. Malaria causes anaemia, as well as the decrease of the blood level in antioxidants including vitamin A. The investigations of Shankar and collaborators in 1999 revealed a considerable reduction in the frequency of falciparum malaria episodes in children under a vitamin A suplementation. Otherwise, thanks to the works done in vitro, it is established today that the retinol molecule can also act directly by inhibiting the development of Plasmodium (Hamzah et al, 2004). Although several authors worked on the impact of the vitamin A and iron deficiency on malaria as well as the use of the supplementation as means of prevention of malaria, very little have been done on the persons already infected by Plasmodium. Our study aims to evaluate the potential of vitamin A and iron supplementation on the treatment of malaria in Cameroonian preschool children. Material and methods Type of the survey The present work is based on cli
机译：这项研究调查了维生素A和铁对疟疾的治疗效果，当它们被补充作为感染的学龄前儿童的补充剂时。在安慰剂对照补充试验中，招募了132名年龄在6至60个月之间的儿童，分为4组：第一组每天接受68mg（6-30个月）或102mg（30-60个月）的铁，第二组每天接受30mg的铁。 （6-12个月）或在治疗开始时单次服用60毫克（12-60个月）的维生素A。第三组同时接受维生素A和铁，而安慰剂未接受补充剂。使用WHO（1982）方法获得有关寄生虫血症，临床（体重，生命力）和血液学参数（红细胞，白细胞和血红蛋白）的完整数据，以及通过荧光光谱法和原子吸收分别获得的微量营养素状态（血清维生素A和铁）分光光度法。从这项研究中，观察到约有40.15％的疟疾患儿贫血（所招募的40.15％的婴儿中血红蛋白水平从9.02±1.60到10.72±1.21 g / dl，红细胞水平低于3500000 / mm3） 。他们还患有中度至严重的维生素A缺乏症（血清维生素A在0.53±0.14和0.66±0.24μmol/ l之间）。与安慰剂组相比，接受补充剂治疗的婴儿的临床和亚临床参数（体重增加从0.49±1.48Kg增加到0.64±1.97Kg，安慰剂组为– 0.76±2.17Kg）有显着改善，铁状态（血红蛋白水平从0.63变化） ±1.33至0.94±1.2.10 g / dl，而– 0.68±0.98 g / l）。在补充维生素A的组中（血清水平0.08±0.20至0.11±0.17μmol/ l）观察到维生素A状态显着改善，而未补充维生素A的组（-0.04±0.05μmol/ l）明显减少接受铁的组，安慰剂组为– 0.07±0.13μmol/ l）。与仅接受铁或维生素A的人群相比，接受维生素A或铁补充剂的人群的改善最为重要。这项研究表明，将维生素A和铁作为补充剂用于感染儿童的补充，可以显着改善疟疾的治疗。背景技术青年时期的疟疾感染是在所有热带和亚热带地区发生的主要公共卫生问题。在撒哈拉以南非洲，婴儿死亡的75％是由疟疾造成的，儿童每年感染率从1.6到5.4（WHO，2004）。造成这场灾难的主要原因包括贫困加剧了人们对抗疟疾药物的抗拒频率，卫生基础设施不足以及这些地区广泛的内部动荡（Snow，1999）。面对这种疾病的疯狂发展，在药理学，血液学，免疫学和昆虫学等各个方面的研究都在增加和跟踪。但是，尽管付出了巨大的努力，但始终很难掌握这一诅咒。几十年来，人们特别重视营养在疟疾发展中的重要性。疟疾导致贫血，以及包括维生素A在内的抗氧化剂的血药浓度降低。Shankar和合作者在1999年进行的一项调查显示，补充维生素A的儿童中恶性疟疾发作的频率大大降低。否则，得益于体外完成的工作，如今已确定视黄醇分子还可以通过抑制疟原虫的发生而直接发挥作用（Hamzah等，2004）。尽管有几位作者研究了维生素A和铁缺乏症对疟疾的影响以及使用该补充剂作为预防疟疾的手段，但对已经被疟原虫感染的人所做的工作很少。我们的研究旨在评估喀麦隆学龄前儿童中维生素A和铁的补充治疗疟疾的潜力。材料和方法调查类型本工作基于cli

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