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The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya

Leenstra, T, Kariuki, S K, Kurtis, J D, Oloo, A J, Kager, P A and terKuile, Feiko (2009) 'The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya'. European Journal of Clinical Nutrition, Vol 63, Issue 2, pp. 173-182.

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Abstract

Background/Objectives:
Iron deficiency anemia is a major public health problem in developing countries and may affect school performance and physical work capacity in nonpregnant adolescents, and may increase the risk of anemia during subsequent teenage pregnancies. We assessed the effect of weekly iron (120 mg elemental iron) and vitamin A (25 000 IU) supplementation on hemoglobin, iron status and malaria and nonmalaria morbidity in adolescent schoolgirls.

Subjects/Methods:
A total of 279 schoolgirls aged 12–18 years from public primary schools in Kisumu, western Kenya. Double-blind randomized placebo-controlled trial using a factorial design.

Results:
Five months of iron supplementation was associated with a 0.52 g dl−1 (0.21, 0.82) greater increase in hemoglobin relative to iron placebo. The effect was only observed in girls with iron deficiency on enrollment (1.34 g dl−1 (0.79, 1.88)), but not in iron-replete girls (−0.20 g dl−1 (−0.59, 0.18)). Similar differences in treatment effect were seen between menstruating and nonmenstruating girls. The effect of iron was independent of vitamin A. The baseline prevalence of vitamin A deficiency was low (6.7%) and no sustained increase in hemoglobin was seen with weekly vitamin A (−0.07 g dl−1 (−0.38, 0.25)). Incidence of malaria parasitemia was higher in the iron than iron-placebo groups (Rate ratio 1.33 (0.94, 1.88)).

Conclusions:
Weekly iron supplementation results in substantial increases in hemoglobin concentration in adolescent schoolgirls in western Kenya, which may outweigh possible risks caused by malaria, but only in iron-deficient or menstruating girls and not in iron-replete and nonmenstruating girls.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Digital Object Identifer (DOI): https://doi.org/10.1038/sj.ejcn.1602919
Depositing User: Martin Chapman
Date Deposited: 02 Jun 2014 14:57
Last Modified: 07 Jun 2018 14:39
URI: http://archive.lstmed.ac.uk/id/eprint/3747

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