News Release

Simple diagnosis of anaemia and malaria

Peer-Reviewed Publication

Netherlands Organization for Scientific Research

Research funded by NWO has shown that African mothers greatly over-report fever in their children. As a result the children are given anti-malaria drugs too often. African households seldom possess a thermometer. Another outcome of the study is that it opens up the possibility of detecting anaemia at village level using a new and simple method.

Studies showed that many mothers stated that their sick child had a fever after feeling its forehead, even though its body temperature was normal. In practice, this frequently leads to the child being wrongly diagnosed as suffering from malaria, particularly if there is no health centre nearby which can confirm that the child in fact has a fever. When laboratory tests are not feasible, the presence of fever is sufficient reason to administer malaria drugs.

The researchers at Wageningen University and Research Centre came across this over-reporting of malaria by chance. They were actually investigating the relationship between iron deficiency, malaria and anaemia. Doctors are cautious about giving iron supplements to young children in areas where malaria is endemic because in the past this led to extra cases of malaria among Ethiopian refugees. However, in their research (carried out in Kenya), the Wageningen research team did not find that the number of cases increased. Administering iron supplements in fact led to the children’s health and growth improving. The researchers believe that extra iron is only dangerous for extremely weak and undernourished children who have hardly any resistance to disease. The sample studied was not large enough, however, for the team to be certain of how safe it is to administer iron supplements.

The NWO researchers examined children aged between three months and three years. No less than 69% of them were found to be anaemic, mainly as a result of iron deficiency. This is a common problem in poor families where the children do not consume much in the way of animal products.

The relationships between anaemia, iron deficiency and malaria are complex. Anaemia, for example, is one of the consequences of malaria because the malaria parasite destroys red blood cells. On the other hand, it is possible that in very weak children a lack of iron actually protects them against malaria.

The study also focused on a new test for anaemia. This involves placing a drop of blood on a filter paper and comparing it with sample cards showing different shades of red. The cards indicate the concentration of red blood cells for each colour. The method seems to be effective and it is extremely suitable in tropical countries as a means of determining which children need extra iron.

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