Institute takes lead on international iron trials

Institute takes lead on international iron trials

Illuminate newsletter index page, March 2019
March 2019

Malawi iron trial
The first pregnant woman to receive intravenous iron as part
of the newly launched trial in Malawi, Africa.

One of the largest international efforts to prevent and treat iron deficiency in mothers and babies in low-income countries has been launched by Institute researchers.

The study will also investigate the impacts of iron on the developing infant brain. Institute haematologist Dr Sant-Rayn Pasricha is leading the research along with collaborators at the University of Melbourne, University of Malawi, and the International Centre for Diarrhoeal Diseases Research in Bangladesh.

Chasing an ambitious target

Anaemia is one of the most avoidable causes of illness and death in low-income countries, with serious health implications for hundreds of millions of mothers and babies. Dr Pasricha said the World Health Organisation (WHO) had set an ambitious target of halving the prevalence of anaemia in women by 2025.  There has been almost no progress towards achieving the WHO target. Our efforts are aiming to change that.

"Through these pivotal trials, we want to find efficient and effective treatment strategies to help women and children reach their full iron needs."

The trials, which have opened in Malawi and Bangladesh, are aiming to recruit more than 6000 women and children.

Dr Pasricha said he hoped the findings would provide governments and WHO with vital knowledge to improve public health policy by “providing a rationale for the allocation of government funds and resources, as well as improvements for administering iron through public health programs worldwide.”

Current oral options failing mothers

Current oral treatment approaches in lower-income communities in Africa and Asia are having a particularly devastating impact on global maternal health.

Dr Pasricha said current iron pill programs in poorer areas were ineffective because they required multiple healthcare centre visits over an extended period of time.

“The level of diligence required to keep up a full course of iron pills, along with limited access to medical centres, and poor health infrastructure means an overwhelming number of pregnant women aren’t getting the iron they need,” he said.

Hope for an intravenous booster

The Malawi-based trial is aiming to test the impact of an intravenous iron treatment used successfully in some countries, such as Australia, which can safely and rapidly boost a patient’s iron count to recommended levels in one 15-minute session.

Dr Pasricha said that in addition to the life-saving benefits for mothers, previous studies had shown that “successful iron interventions increased gestation periods by half a week, almost halved the incidence of prematurity and improved birthweights by 150 grams.”

With the help of trained psychologists, the trials will also gather evidence on the impact of iron on cognitive development, behaviour and physical growth measures such as height and weight.

Professor Kamija Phiri, chair of Clinical Epidemiology at the University of Malawi, said the studies would inform a clinical rationale and the cost-benefit analysis for implementing the best treatment methods in any low-to-mid-income country setting.

“We are excited about making an important contribution to one of the biggest challenges facing women and children in underserved populations, with broader lessons about the impact of iron on the brain and body.”

The research is supported by the Bill & Melinda Gates Foundation and the Australian Government’s National Health and Medical Research Council.


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