Malaria and Iron Load at the First Antenatal Visit in the Rural South Kivu, Democratic Republic of the Congo: Is Iron Supplementation Safe or Could It Be Harmful?

Esto Bahizire Center of Research in Epidemiology, Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium;
Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, DR Congo;
Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya;

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Umberto D’Alessandro Medical Research Council Unit The Gambia, Fajara, The Gambia;
London School of Hygiene and Tropical Medicine, London, United Kingdom;

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Michèle Dramaix Center of Research in Epidemiology, Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium;

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Nicolas Dauby Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium;

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Fabrice Bahizire Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya;

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Kanigula Mubagwa Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium;

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Philippe Donnen Center of Research in Health Policy and Systems-International Health, Université Libre de Bruxelles, Brussels, Belgium

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We investigated the relationship between malaria infection and iron status in 531 pregnant women in South Kivu, Democratic Republic of the Congo. Sociodemographic data, information on morbidity, and clinical data were collected. A blood sample was collected at the first antenatal visit to diagnose malaria and measure serum ferritin (SF), soluble transferrin receptor, C-reactive protein, and α1-acid-glycoprotein. Malaria prevalence was 7.5%. Median (interquartile range) SF (adjusted for inflammation) was significantly higher in malaria-infected (82.9 μg/L [56.3–130.4]) than in non-infected (39.8 μg/L [23.6–60.8]) women (P < 0.001). Similarly, estimated mean body iron store was higher in malaria-infected women (P < 0.001). Malaria was significantly and independently associated with high levels of SF. Efforts to improve malaria prevention while correcting iron deficiency and anemia during pregnancy are warranted.

Author Notes

Address correspondence to Esto Bahizire, Center of Research in Epidemiology, Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium, Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, DR Congo, Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya. E-mail: ebahizir@ulb.ac.be

Financial support: This study was supported by grants from the Belgian “Commission Universitaire pour le Développement” (CUD) and VLIR-UOS.

Authors’ addresses: Esto Bahizire, Center of Research in Epidemiology, Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium, Centre de Recherche en Sciences Naturelles de Lwiro, Bukavu, DR Congo, and Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya, E-mail: ebahizir@ulb.ac.be or esto.bahizire@gmail.com. Umberto D’Alessandro, Medical Research Council Unit The Gambia, Fajara, Banjul, The Gambia, and London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: udalessandro@mrc.gm. Michèle Dramaix, Center of Research in Epidemiology, Biostatistics and Clinical Research, Université Libre de Bruxelles, Brussels, Belgium, E-mail: michele.dramaix@ulb.ac.be. Nicolas Dauby, Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium, E-mail: nicolas_dauby@stpierre-bru.be. Fabrice Bahizire, Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya, E-mail: fabricebahizire89@gmail.com. Kanigula Mubagwa, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium, E-mail: kanigula.mubagwa@med.kuleuven.ac.be. Philippe Donnen, Center of Research in Health Policy and Systems-International Health, Université Libre de Bruxelles, Brussels, Belgium, E-mail: pdonnen@ulb.ac.be.

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