Iron-chelating agents for treating malaria

Malaria is a major health problem that particularly affects people living in sub-Saharan Africa and other tropical parts of the world. It often causes considerable morbidity and high mortality, especially in children under five, and is passed by mosquito bites from infected female mosquitoes. Several drugs are available to treat malaria infections, and there are also additional drugs that can be used to increase effectiveness. Since parasites require iron to reproduce, drugs that withhold available iron (ie iron-chelating drugs) from the parasite could inhibit the parasite reproduction rate and may be used as adjuncts to traditional antimalarial drugs. However, the agents may also reduce the availability of iron to the individual, and this may contribute to or exacerbate anaemia. There are a number of different iron-chelating agents, such as desferrioxamine (DFO) and deferiprone, and all were considered in the review of trials, although DFO has to be given intravenously and so will be of little use in most malarious areas. The drugs may also display adverse effects like headaches, dizziness, muscle pain, and tiredness. The review found seven trials of DFO and deferiprone involving 570 participants. Although the drugs may have helped in part with parasite levels, there seemed to be adverse effects including concerns about possibility of an increase in death. There is insufficient evidence to support the use of iron-chelating agents as adjuncts in the treatment of malaria, and further trials are not expected.