Volume 74, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Whether administration of folic acid to children with malaria anemia is helpful is controversial. Therefore, we conducted a randomised, placebo-controlled trial of 14 days of treatment with folic acid (1 mg/d) in Zambian children with malaria anemia treated with either sulfadoxine/pyrimethamine (SP) or atovaquone/proguanil (AP). Among children who received SP, the prevalence of parasitemia was higher in children treated with folic acid than among those given placebo at days 3, 7, and 14 after the start of treatment, and the difference at day 3 was statistically significant ( = 0.013). Folic acid treatment had no effect on parasitemia in children treated with AP. Administration of folic acid led to a small increase in packed cell volume over that seen in the placebo group at days 14 and 28 after the start of treatment.


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  1. Biemba G, Dolmans D, Thuma PE, Weiss G, Gordeuk VR, 2000. Severe anaemia in Zambian children with Plasmodium falciparum malaria. Trop Med Int Health 5 : 9–16. [Google Scholar]
  2. Gera T, Sachdev HP, 2002. Effect of iron supplementation on incidence of infectious illness in children: systematic review. Br Med J 325 : 1142–1144. [Google Scholar]
  3. Menendez C, Fleming AF, Alonso PL, 2000. Malaria-related anaemia. Parasitol Today 16 : 469–476. [Google Scholar]
  4. Fleming AF, 1981. Haematological manifestations of malaria and other parasitic diseases. Clin Haematol 10 : 983–1011. [Google Scholar]
  5. Abdalla SH, 1990. Iron and folate status in Gambian children with malaria. Ann Trop Paediatr 10 : 265–272. [Google Scholar]
  6. Watkins WM, Sixsmith DG, Chulay JD, Spencer HC, 1985. Antagonism of sulfadoxine and pyrimethamine anti-malarial activity in vitro by p- aminobenzoic acid, p-aminobenzoyl-glutamic acid and folic acid. Mol Biochem Parasitol 14 : 55–61. [Google Scholar]
  7. Oppenheimer SJ, Cashin P, 1986. Serum and red cell folate levels associated with malarial parasitaemia. Trans R Soc Trop Med Hyg 80 : 169–177. [Google Scholar]
  8. Das KC, Virdi JS, Herbert V, 1992. Survival of the dietary deprived: folate deficiency protects against malaria in primates. Blood 80 : 281a. [Google Scholar]
  9. Boele van-Hensbroek M, Morris-Jones S, Meisner S, Jaffar S, Bayo L, Dackour R, Phillips C, Greenwood BM, 1995. Iron, but not folic acid, combined with effective anti-malarial therapy promotes haematological recovery in African children after acute falciparum malaria. Trans R Soc Trop Med Hyg 89 : 672–676. [Google Scholar]
  10. Carter JY, Loolpaptit MP, Lema OE, Tome JL, Nagelkerke NJD, Watkins WM, 2005. Folic acid supplementation reduces the efficacy of antifolate anti-malarial therapy. Am J Trop Med Hyg 73 : 166–170. [Google Scholar]
  11. Dzinjalamala FK, Macheso A, Kublin JG, Taylor TE, Barnes KI, Molyneux ME, Plowe CV, Smith PJ, 2005. Blood folate concentrations and in vivo sulfadoxine- pyrimethamine failure in Malawian children with uncomplicated Plasmodium falciparum malaria. Am J Trop Med Hyg 72 : 267–272. [Google Scholar]
  12. World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94 (Suppl 1): S1–S90. [Google Scholar]
  13. Snounou G, 2002. Genotyping of Plasmodium spp. nested PCR. Methods Mol Med 72 : 103–116. [Google Scholar]
  14. Ekval H, 2003. Malaria and anemia. Curr Opin Hematol 10 : 108–114. [Google Scholar]
  15. Verhoeff FH, 2001. Iron Deficiency and Malaria as Determinants of Anaemia in African Children. Universal Press: Veenendaal, The Netherlands.

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  • Received : 14 Dec 2005
  • Accepted : 13 Feb 2006

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