British Journal of Nutrition

Research Article

Haematological response to iron supplementation is reduced in children with asymptomatic Helicobacter pylori infection

Dilip Mahalanabisa1 c1, M. Aminul Islama2, Saijuddin Shaikha1, Monilal Chakrabartya3, Anura V. Kurpada4, Swagata Mukherjeea5, Bandana Sena1, M. Abu Khaleda2 and Sten H. Vermunda2

a1 Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata – 700 054, India

a2 University of Alabama at Birmingham, Birmingham, Alabama, USA

a3 Kothari Medical Research Centre, Kolkata, India

a4 St. Johns Medical College, Bangalore, India

a5 Infectious Diseases Hospital, Kolkata, India


We evaluated the adverse effect of asymptomatic Helicobacter pylori infection in children on the response to Fe supplementation. One hundred and sixty-nine children aged 1–10 years from the urban poor community underwent a [13C]urea breath test for H. pylori and haematological tests at admission and after 8 weeks. Both H. pylori-positive and -negative children were randomly assigned to receive ferrous fumarate syrup (20 mg elemental Fe twice daily) or placebo for 8 weeks and a single dose of vitamin A (33,000μg). Admission findings were compared between H. pylori-positive and -negative children. Response to Fe was compared between Fe-supplemented H. pylori-positive and -negative children. Seventy-nine per cent of the children were aged 1–5 years and half of them were boys. In eighty-five H. pylori-positive and eighty-four H. pylori-negative children, the differences in mean Hb (112 (sd 12·6) v. 113 (sd 12·0) g/l), haematocrit (34 (sd 3·5) v. 35 (sd 3·2) %) and ferritin (23·8 v. 21·0 μg/l) were similar. After 8 weeks of Fe supplementation, mean Hb was 5·3 g/l more (95 % CI 1·59, 9·0) and haematocrit was 1·4 % more (95 % CI 0·2, 2·6) in H. pylori-negative (n 44) compared with H. pylori-positive (n 42) children. Mean ferritin was similar at admission and improved in both H. pylori-positive and -negative children. Asymptomatic H. pylori infection was not associated with higher rates of anaemia or Fe deficiency in children, but had a significant adverse effect on response to Fe therapy. However, this result is based on exploratory analysis and needs confirmation.

(Received November 11 2004)

(Revised May 20 2005)

(Accepted July 20 2005)


c1 *Corresponding author: Dr Dilip Mahalanabis, fax +91 33 2337 6290, email