A WHO collaborative study on iron supplementation in Burma and in Thailand

Charoenlarp, P; Dhanamitta, Sakorn; Kaewvichit, R; Silprasert, A; Suwanaradd, C; Na-Nakorn, S; Prawatmuang, P; S, Vatanavicharn; Nutcharas, U; Pootrakul, Pensri

doi:10.1093/ajcn/47.2.280

Cited by 73 publications

(52 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The hemoglobin concentrations and serum ferritin concentrations of both Hb E and nonthalassemic groups declined after routine iron supplementation (Table 3). The different results obtained in our study compared with the previous study (19) are possibly due to the different times of measurement and globin genotypes of the subjects. In our study, the medians for the first and second measurements were 13 and 32 wk of gestation, respectively, whereas in the former study (19) the second measurement was done at 32-36 wk of gestation and globin genotype was not determined.…”

Section: Discussioncontrasting

confidence: 97%

“…To our knowledge, there has been only one study conducted before in the northeastern part of Thailand that compared hemoglobin response to iron supplementation in pregnancy between normal hemoglobin type (Hb AA) and heterozygous Hb E (Hb EA) (19). In this previous study, a significant difference was observed in the rise of hemoglobin concentration between pregnant women with Hb AA and Hb EA after 15 wk of iron supplementation and subjects with Hb EA did not achieve the same hemoglobin concentration as those with Hb AA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of the maternal βE-globin gene on hematologic responses to iron supplementation during pregnancy

Sanchaisuriya

Fucharoen

Ratanasiri

et al. 2007

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

Background: It is customary in Southeast Asia to treat pregnant anemic women with iron supplements, but anemia in this region may be complicated by thalassemia and hemoglobinopathies, which lead to an ineffective response. Objective: The aim was to determine whether routine iron supplementation during pregnancy in this area, which has a high prevalence of thalassemia and hemoglobinopathies, is an effective control strategy for iron deficiency anemia. Design: A prospective study was conducted. Seventy-six pregnant women, including 43 who were heterozygous for the hemoglobin E (Hb E) gene, 20 who were heterozygous for Hb E and had ␣-thalassemia, and 13 who were homozygous Hb E, as well as 77 pregnant women who had no thalassemia gene, participated in this investigation. All pregnant women received a daily dose of 120 mg elemental Fe for an average of 133.5 d. Hematologic variables and serum ferritin concentrations were measured before supplementation and after supplementation at the gestational age of 28 -32 wk. Differences in hematologic variables and serum ferritin were assessed. Results: Significant differences in hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin responses were found between the nonthalassemia group and the 3 groups with the Hb E gene after adjustment for the following baseline values: age, body mass index, duration of iron supplementation, and ferritin concentration. Significant differences in the improvements in mean corpuscular volume and mean corpuscular hemoglobin values between the 3 groups indicate a poorer response at the cellular level in the pregnant women with the Hb E gene. Further analysis showed a significant difference in the hemoglobin response only for women who were homozygous for Hb E. Conclusion: Iron supplementation during pregnancy is not beneficial for pregnant women who are homozygous for Hb E, but a routine intervention should not cause iron overload, as judged from this short observation period.Am J Clin Nutr 2007;85:474 -9.

show abstract

Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Effect of the maternal βE-globin gene on hematologic responses to iron supplementation during pregnancy

Sanchaisuriya

Fucharoen

Ratanasiri

et al. 2007

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

show abstract

“…Three months of daily supplementation with 1 mg folic acid and multivitamin during the postpartum period produced slight, though signi®cant, increases in mean Hb and Hct levels (2 g l -1 and and 0.008, respectively) compared to multivitamin use alone among lactating American women 77 . However, no bene®t of folic acid supplementation on Hb response was observed in trials among either non-pregnant Thai women 67 or Malaysian adolescent girls 78 . In the latter study, however, plasma ferritin increased signi®cantly following supplementation with iron and folate, but decreased in the folate-alone group, suggesting that folate may have stimulated synthesis of Hb from existing iron stores.…”

Section: Folatementioning

confidence: 97%

“…2. May lessen the severity of anaemia of prematurity among young infants, although no large trials have 67 .…”

Section: Folatementioning

confidence: 99%

The role of vitamins in the prevention and control of anaemia

Fishman

Christian

West

2000

Public Health Nutr.

265

208

View full text Add to dashboard Cite

Objective: While iron de®ciency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B 12 , C and E, folic acid and ribo¯avin status have also been linked to its development and control. This paper provides a systematic review of vitamin supplementation trials relating to the control of nutritional anaemia. Methods: A MEDLINE search was used to ®nd reports of vitamin supplementation trials that reported changes in anaemia or iron status. Results: Vitamin A can improve haematological indicators and enhance the ef®cacy of iron supplementation. Both folate and vitamin B 12 can cure and prevent megaloblastic anaemia. Ribo¯avin enhances the haematological response to iron, and its de®ciency may account for a signi®cant proportion of anaemia in many populations. Vitamin C enhances the absorption of dietary iron, although population-based data showing its ef®cacy in reducing anaemia or iron de®ciency are lacking. Vitamin E supplementation given to preterm infants has not reduced the severity of the anaemia of prematurity. Vitamin B 6 effectively treats sideroblastic anaemia. Multivitamin supplementation may raise haemoglobin (Hb) concentration, but few studies have isolated the effect of multivitamins from iron on haematological status. Conclusions: In general, the public health impact of vitamin supplementation in controlling anaemia is not clear. Neither are the complex interactions involving multiple vitamins in haematopoiesis suf®ciently understood to explain the observed variability in haematological responses to vitamins by age, population, vitamin mixture and dosages. Further research is needed to understand the roles of individual and combined vitamin de®ciencies on anaemia to design appropriate micronutrient interventions to prevent anaemia.

show abstract

“…Compliance has been reported to be influenced by the undesirable side effects brought about by iron tablet intake, which are related to the amount, frequency and duration of intake, and form of the tablets (Charoenlarp et al, 1988;Aguayo et al, 2005). Side effect is dose related as seen in studies conducted among Malaysian adolescent girls (Tee et al, 1999) and Bangladeshi pregnant women (Hyder et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

The effect of a school-based weekly iron supplementation delivery system among anemic schoolchildren in the Philippines

et al. 2007

View full text Add to dashboard Cite

Objective: To determine the effect of a school-based weekly iron supplementation delivery system (WISDS) on the prevalence of anemia among anemic schoolchildren. Subjects and methods: Two hundred and forty-two Filipino schoolchildren aged 6-12 years with hemoglobin (Hb) concentration o12 g/dl and enrolled for school year [2003][2004]. UNICEF iron-folate tablets containing 60 mg elemental iron and 0.40 mg folic acid were given weekly through directly observed supplementation by the teachers for 27 weeks. Compliance to iron supplementation was monitored by the teachers and was recorded using a monitoring form and a supplementation calendar. Hb concentration, weight and height were determined at baseline and at post-intervention. Results: At post-intervention, the participants' mean Hb concentration increased by 0.4 g/dl (95% confidence interval ¼ 0.3, 0.5 g/dl; Po0.0001), anemia prevalence was reduced by 53.7, and 84.3% of the participants had 100% compliance to supplementation. Conclusions: The school-based WISDS reduced anemia prevalence among anemic schoolchildren and resulted in high compliance to and coverage of iron supplementation.

show abstract

A WHO collaborative study on iron supplementation in Burma and in Thailand

Cited by 73 publications

References 6 publications

Effect of the maternal βE-globin gene on hematologic responses to iron supplementation during pregnancy

Effect of the maternal βE-globin gene on hematologic responses to iron supplementation during pregnancy

The role of vitamins in the prevention and control of anaemia

The effect of a school-based weekly iron supplementation delivery system among anemic schoolchildren in the Philippines

Contact Info

Product

Resources

About