Effect of Anemia, Malaria and Helminthes Infections on Stability of Red Blood Cell Iron Isotope Enrichment in Zanzibari Toddlers (P24-058-19). (13th June 2019)

• Record Type: Journal Article
• Authors: Kang, Wanhui; Baer, Nathaniel; Ramsan, Mahdi; Vermeylen, Francoise; Stoltzfus, Rebecca; O'Brien, Kimberly
• Is Part Of: Current developments in nutrition. Volume 3(2019)Supplement 1
• Publication Date: 2019-06-13
• Subjects: Nutrition -- Periodicals; Nutritional Physiological Phenomena; Nutrition; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 612.3
• DOI: 10.1093/cdn/nzz044.P24-058-19
• Languages: English
• ISSNs: 2475-2991

Abstract

Abstract: Objectives: The study was undertaken to identify the impact of malarial and geo-helminthes infections on the stability of red blood cell (RBC) iron (Fe) isotope enrichment among a group of Zanzibari toddlers at high risk for parasitic infections. Methods: A total of 71 toddlers (16 - 25 months) were recruited. At entry (D0), baseline blood was taken and an oral dose of 58 Fe or 57 Fe tracer (7 mg total Fe as FeS04 ) was administered to fasted toddlers. Complete stool collections were obtained for 3 days post-dosing. Blood was collected 14 (D14) and 90 days (D90) post-dosing for assessment of Fe status indicators and RBC isotopic enrichment. At D14 and D90 blood and stool samples were collected and screened for malaria parasites and geo-helminth burden respectively. Results: At baseline, mean hemoglobin (Hb) concentration was 10.83 ± 1.46 g/dL (mean ± SD, n = 71) and 57% of toddlers were anemic (Hb < 11 g/dL). At enrollment 37% of toddlers had helminth infections, 16% had a positive blood smear for malarial parasites and 9% of all toddlers recruited were infected with both parasites. RBC Fe enrichment decreased significantly from D14 to D90 (70 days) by −2.75 ± 0.554% ( n = 66). Children with lower Hb concentrations on D0 and D14 had greater loss of RBC isotope Fe enrichment over the study period of 70 days ( P < 0.005, r = −0.35 and r = −0.37, n = 66). Rates of loss in RBC Fe enrichment were greater among those with helminthes ( P = 0.05, n = 64) or any parasitic infection ( P = 0.02, n = 65) during the study period. Children with undetectable hepcidin (<5 µg/L) on D90 had the greatest stability of RBC Fe isotope and the rate of RBC Fe loss was significantly lower than evident among children with detectable hepcidin on D90 ( P = 0.003, n = 38). The rate of RBC Fe loss was not significantly influenced by gender, anthropometric measures or other iron indicators (sTfR, ferritin, body iron, EPO, CRP, folate/B 12). Additionally, the higher the % RBC Fe incorporation at D14, the higher the subsequent loss of RBC Fe enrichment over the following 70 days ( P < 0.0001, n = 65, r = 0.5048). Conclusions: Toddlers exhibited a significantly higher utilization of RBC Fe when they were anemic or had larger Fe demands due to parasitic infections. Funding Sources: The Wellcome Trust Foundation.