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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Multiple micronutrients including iron are not more effective than iron alone for improving hemoglobin and iron status of Malian school children
Journal of Nutrition, Volume 139, No. 10, Year 2009
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Description
Iron deficiency and anemia remain among the most important global public health problems facing school children. Helminth infections often peak at school age and aggravate nutritional risks. We conducted a 12-wk randomized controlled trial in 406 Malian anemic schoolchildren infected with Schistosoma hematobium to examine the effects of 2 doses of praziquantel (P) (40 mg/kg body weight), P + 60 mg/d iron (Fe), and/or a multiple micronutrient supplement (MM) that included 18 mg/d Fe. Supplements were administered to the children each school day (5 d/wk) throughout the study. Changes in hemoglobin (Hb), serum ferritin (SF), and serum transferrin receptors (s-TfR) were followed. We also examined interactions between Fe and MM supplements on Hb and SF concentrations and malaria incidence. The effects of Fe on Hb and SF concentrations were greater than the effects of P alone and MM with or without added Fe at 6 and 12 wk (P < 0.001). In all groups, s-TfR decreased at 6 and 12 wk compared with baseline. The decrease was most pronounced in the P + Fe group compared with the other 3 groups at wk 6 (P = 0.05). Fe and MM interacted negatively at wk 6 and 12 to affect Hb (β = -0.43, 95% CI = -0.77, -0.09; P = 0.01 and β = -0.47, 95% CI = -0.83, -0.11; P = 0.01, respectively) and SF (β = -0.42, 95% CI = -25.60, 12.31; P < 0.001, and β = -0.37, 95% CI = -0.63, -0.12; P = 0.004, respectively). Malaria incidence was higher in the groups treated with added Fe (relative risk: 1.66; 95% CI: 0.75, 3.67). In this context, MM with added iron were not more effective than Fe without MM. Fe supplementation of schoolchildren with 60 mg/d for anemia control should be considered carefully. © 2009 American Society for Nutrition.
Authors & Co-Authors
Ayoya, Mohamed Ag
United States, New York
Unicef
Spiekermann-Brouwer, Gerburg Maria
United States, Ithaca
Cornell University
Traoré, Abdel Kader
Mali, Bamako
University of Bamako
Stoltzfus, Rebecca Joyce
United States, Ithaca
Cornell University
Habicht, Jean Pierre L.
United States, Ithaca
Cornell University
Garza, Cutberto
United States, Chestnut Hill
Boston College
Statistics
Citations: 19
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.3945/jn.109.106625
ISSN:
00223166
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative