Evidence map›Paper›PMID 32403115›Full record

Trial reportPediatric research2020

Delayed iron does not alter cognition or behavior among children with severe malaria and iron deficiency.

Andrew S Ssemata, Meredith Hickson, John M Ssenkusu, Sarah E Cusick, Noeline Nakasujja, Robert O Opoka, Maria Kroupina, Michael K Georgieff, Paul Bangirana, Chandy C John

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Pediatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Andrew S Ssemata *Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
Meredith Hickson *Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
John M SsenkusuDepartment of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, Kampala, Uganda.
Sarah E CusickDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
Noeline NakasujjaDepartment of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
Robert O OpokaDepartment of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Maria KroupinaDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
Michael K GeorgieffDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
Paul BangiranaDepartment of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
Chandy C JohnDepartment of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA. chjohn@iu.edu.
Makerere University · UGUniversity of Minnesota Medical Center · USChildren's Hospital of Philadelphia · USIndiana University School of Medicine

Funding

Severe Malaria And Risk to The Brain (SMART Brain)R01NS055349 · NINDS · UNIVERSITY OF MINNESOTA · PI Chandy C. John, Ruth Namazzi · 2008 to 2026
$11.2M
Research training in infection, nutrition and neurodevelopment in UgandaD43TW010928 · FIC · INDIANA UNIVERSITY INDIANAPOLIS · PI Chandy C. John · 2018 to 2026
$1.9M
Research Training in Infection and Neurodevelopment in UgandaD43NS078280 · NINDS · UNIVERSITY OF MINNESOTA · PI JOHN, CHANDY C. · 2011 to 2015
$1.1M
Acute vs. delayed iron therapy: effect on iron status, anemia and cognitionU01HD064698 · NICHD · UNIVERSITY OF MINNESOTA · PI JOHN, CHANDY C. · 2009 to 2013
$916k
FIC NIH HHS D43 TW010928NICHD NIH HHS U01 HD064698NINDS NIH HHS D43 NS078280NINDS NIH HHS R01 NS055349
6 · The paper itself

Abstract

backgroundMalaria and iron deficiency (ID) in childhood are both associated with cognitive and behavioral dysfunction. The current standard of care for children with malaria and ID is concurrent antimalarial and iron therapy. Delaying iron therapy until inflammation subsides could increase iron absorption but also impair cognition.

methodsIn this study, Ugandan children 18 months to 5 years old with cerebral malaria (CM, n = 79), severe malarial anemia (SMA, n = 77), or community children (CC, n = 83) were enrolled and tested for ID. Children with ID were randomized to immediate vs. 28-day delayed iron therapy. Cognitive and neurobehavioral outcomes were assessed at baseline and 6 and 12 months (primary endpoint) after enrollment.

resultsAll children with CM or SMA and 35 CC had ID (zinc protoporphyrin concentration ≥80 μmol/mol heme). No significant differences were seen at 12-month follow-up in overall cognitive ability, attention, associative memory, or behavioral outcomes between immediate and delayed iron treatment (mean difference (standard error of mean) ranged from -0.2 (0.39) to 0.98 (0.5), all P ≥ 0.06).

conclusionsChildren with CM or SMA and ID who received immediate vs. delayed iron therapy had similar cognitive and neurobehavioral outcomes at 12-month follow-up. IMPACT: The optimal time to provide iron therapy in children with severe malaria is not known. The present study shows that delay of iron treatment to 28 days after the malaria episode, does not lead to worse cognitive or behavioral outcomes at 12-month follow-up. The study contributes new data to the ongoing discussion of how best to treat ID in children with severe malaria.

Indexed as

Iron DeficienciesAnemia, Iron-DeficiencyAttentionBehaviorChild Behavior DisordersChild, PreschoolCognitionDrug Administration ScheduleEmotionsFemaleFollow-Up StudiesHemeHumansInfantIronMalaria, CerebralHemeIronProtoporphyrinszinc protoporphyrin

Identifiers

PMID32403115
PMCPMC7483848
OpenAlexW3024316789

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.