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Oral iron supplements for children in malaria-endemic areas

Overview of attention for article published in Cochrane database of systematic reviews, February 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

Mentioned by

news
2 news outlets
blogs
1 blog
policy
1 policy source
twitter
40 tweeters
facebook
7 Facebook pages
wikipedia
1 Wikipedia page

Citations

dimensions_citation
53 Dimensions

Readers on

mendeley
232 Mendeley
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Title
Oral iron supplements for children in malaria-endemic areas
Published in
Cochrane database of systematic reviews, February 2016
DOI 10.1002/14651858.cd006589.pub4
Pubmed ID
Authors

Ami Neuberger, Joseph Okebe, Dafna Yahav, Mical Paul

Abstract

Iron-deficiency anaemia is common during childhood. Iron administration has been claimed to increase the risk of malaria. To evaluate the effects and safety of iron supplementation, with or without folic acid, in children living in areas with hyperendemic or holoendemic malaria transmission. We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library, MEDLINE (up to August 2015) and LILACS (up to February 2015). We also checked the metaRegister of Controlled Trials (mRCT) and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) up to February 2015. We contacted the primary investigators of all included trials, ongoing trials, and those awaiting assessment to ask for unpublished data and further trials. We scanned references of included trials, pertinent reviews, and previous meta-analyses for additional references. We included individually randomized controlled trials (RCTs) and cluster RCTs conducted in hyperendemic and holoendemic malaria regions or that reported on any malaria-related outcomes that included children younger than 18 years of age. We included trials that compared orally administered iron, iron with folic acid, and iron with antimalarial treatment versus placebo or no treatment. We included trials of iron supplementation or fortification interventions if they provided at least 80% of the Recommended Dietary Allowance (RDA) for prevention of anaemia by age. Antihelminthics could be administered to either group, and micronutrients had to be administered equally to both groups. The primary outcomes were clinical malaria, severe malaria, and death from any cause. We assessed the risk of bias in included trials with domain-based evaluation and assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We performed a fixed-effect meta-analysis for all outcomes and random-effects meta-analysis for hematological outcomes, and adjusted analyses for cluster RCTs. We based the subgroup analyses for anaemia at baseline, age, and malaria prevention or management services on trial-level data. Thirty-five trials (31,955 children) met the inclusion criteria. Overall, iron does not cause an excess of clinical malaria (risk ratio (RR) 0.93, 95% confidence intervals (CI) 0.87 to 1.00; 14 trials, 7168 children, high quality evidence). Iron probably does not cause an excess of clinical malaria in both populations where anaemia is common and those in which anaemia is uncommon. In areas where there are prevention and management services for malaria, iron (with or without folic acid) may reduce clinical malaria (RR 0.91, 95% CI 0.84 to 0.97; seven trials, 5586 participants, low quality evidence), while in areas where such services are unavailable, iron (with or without folic acid) may increase the incidence of malaria, although the lower CIs indicate no difference (RR 1.16, 95% CI 1.02 to 1.31; nine trials, 19,086 participants, low quality evidence). Iron supplementation does not cause an excess of severe malaria (RR 0.90, 95% CI 0.81 to 0.98; 6 trials, 3421 children, high quality evidence). We did not observe any differences for deaths (control event rate 1%, low quality evidence). Iron and antimalarial treatment reduced clinical malaria (RR 0.54, 95% CI 0.43 to 0.67; three trials, 728 children, high quality evidence). Overall, iron resulted in fewer anaemic children at follow up, and the end average change in haemoglobin from base line was higher with iron. Iron treatment does not increase the risk of clinical malaria when regular malaria prevention or management services are provided. Where resources are limited, iron can be administered without screening for anaemia or for iron deficiency, as long as malaria prevention or management services are provided efficiently.

Twitter Demographics

The data shown below were collected from the profiles of 40 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 232 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 <1%
South Africa 1 <1%
Pakistan 1 <1%
Mali 1 <1%
Czechia 1 <1%
United Kingdom 1 <1%
United States 1 <1%
Unknown 224 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 60 26%
Student > Bachelor 30 13%
Researcher 25 11%
Student > Ph. D. Student 24 10%
Student > Postgraduate 15 6%
Other 47 20%
Unknown 31 13%
Readers by discipline Count As %
Medicine and Dentistry 89 38%
Nursing and Health Professions 43 19%
Biochemistry, Genetics and Molecular Biology 13 6%
Social Sciences 10 4%
Agricultural and Biological Sciences 10 4%
Other 22 9%
Unknown 45 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 56. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 July 2019.
All research outputs
#317,243
of 13,644,402 outputs
Outputs from Cochrane database of systematic reviews
#843
of 10,696 outputs
Outputs of similar age
#10,309
of 265,799 outputs
Outputs of similar age from Cochrane database of systematic reviews
#22
of 182 outputs
Altmetric has tracked 13,644,402 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,696 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,799 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 182 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.