The Cochrane database of systematic reviews

Folic acid supplements and malaria risk and severity in people using antifolate malaria drugs in affected areas

Updated

Abstract

Eight trials involving 3486 participants examined the effects of folic acid supplementation on malaria outcomes among individuals taking antifolate antimalarials.

  • Folic acid supplementation alone or with iron is associated with lower rates of malaria parasite clearance on day 3 compared to no folic acid.
  • Individuals receiving folic acid and antifolate antimalarials had an increased risk of treatment failure at days 7, 14, and 28.
  • Most trials included folic acid doses above the tolerable upper intake level (> 1.0 mg).
  • One trial using a recommended dose of 400 μg/day showed little to no difference in malaria outcomes.

Simplified

Funding

Competing interests

Yan Ping Qi: No conflicts of interest to declare. Yan Ping Qi is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Krista S Crider: No conflicts of interest to declare. Krista S Crider is a full‐time staff member of the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Julie Gutman: No conflicts of interest to declare. Julie Gutman is astaff member of the CDC and works part‐time as a hospitalist at a children's hospital. Her role as a hospitalist has no relationship to the topic of the reivew. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Elizabeth Centeno Tablante: No conflicts of interest to declare. Amy Fothergill: No conflicts of interest to declare. Amy Fothergill is a full‐time staff member of the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Kelicia Daniels: No conflicts of interest to declare. Kelicia Daniels is a full‐time contractor of Eagle Global Scientific (EGS) supporting a contract at the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of EGS. Lorraine F Yeung: Possesses stocks in Pfizer and Proctor & Gamble. Lorraine Yeung is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Cara T Mai: No conflicts of interest to declare. Cara Mai is a full‐time staff member of the CDC. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Saurabh Mehta: No conflicts of interest to declare. Jennifer L Williams: No conflicts of interest to declare. Jennifer L Williams is a full‐time staff member of the CDC and a clinician with the U.S. Public Health Service. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Julia L Finkelstein: Dr Finkelstein is a principal investigator on research grants to examine the burden and aetiology of anaemia in women of reproductive age, biomarkers of nutritional status in women of reproductive age, and to conduct randomised trials with micronutrient interventions to improve the health of women of reproductive age (National Institutes of Health, U.S. Centers for Disease Control and Prevention, U.S. Department of Agriculture) ‐ not related to this review. Dr. Finkelstein has no known conflicts of interest to declare.
PubMed

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