Inflammation Clinical Trial
Official title:
Acute vs. Delayed Iron Therapy: Effect on Iron Status, Anemia and Cognition
The research questions to be answered by this study are:
1. Is treatment with iron more effective at improving anemia if given at the time of a
malaria episode or 1 month after the episode?
2. Which treatment timing is associated with more malaria episodes - 1 month delayed
treatment or immediate treatment at the time of malaria?
3. Does timing of iron treatment affect later thinking processes and behavior?
The study population in this study will be children who are enrolled in our ongoing study of
cerebral malaria and severe malarial anemia, "Pathogenesis of cognitive/neurologic deficits
in central nervous system malaria", underway in Kampala, Uganda. The pathogenesis study
seeks to address the question of why children with severe malaria have later problems in
thinking. The study we are now proposing will build on this study by assessing whether
children with severe malaria have iron deficiency, and if they do, whether treatment with
iron at the time of malaria is less effective than treatment one month later. We believe
that treatment one month later may be more effective because there is data that shows that
the inflammation that occurs with a malaria episode may decrease the body's ability to
absorb iron in the gut and to send iron to the places it is needed, like the bone marrow and
the brain. We are doing this study to see if our hypothesis about more effective iron
treatment if it is delayed is correct and assessing anemia prevalence, iron status, and
long-term neurobehavioral development as outcomes.
We have three study groups: children with cerebral malaria, children with severe malarial
anemia, and healthy community control children. Children found to be iron deficient will be
randomized to receive iron (as ferrous sulphate syrup) either immediately or at their
one-month follow-up visit. At 1-, 6, and 12-month follow-up visits changes in iron and
inflammation indicators will be assessed. At the 6- and 12-month visits, neurocognitive
behavior will also be evaluated and compared between the immediate vs. delayed iron groups.
Malaria morbidity will be assessed via home visits during the period of iron supplementation
and via clinic monitoring for the duration of the study.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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