Decreased Parasite Load and Improved Cognitive Outcomes Caused by Deworming and Consumption of Multi-Micronutrient Fortified Biscuits in Rural Vietnamese Schoolchildren

Abstract

Abstract. Micronutrient deficiencies are associated with impaired growth and cognitive function. A school-based fortification program might benefit schoolchildren but a high prevalence of parasite infestation might affect effectiveness. A randomized, double-blind, placebo-controlled 2 × 2 factorial trial was conducted to assess the efficacy of multimicronutrient fortified biscuits with or without de-worming on growth, cognitive function, and parasite load in Vietnamese schoolchildren. Schoolchildren (n = 510), 6-8 years of age were randomly allocated to receive albendazole or placebo at baseline and four months of multi-micronutrient fortified biscuits (FB) or non-fortified biscuits. Children receiving FB for four months scored higher on two cognitive tests: Raven's Colored Progressive Matrices and the Digit Span Forward test. Children receiving albendazole plus FB had the lowest parasite load after four months. In children receiving FB, midupper arm circumference was slightly improved (+0.082 cm) but there were no differences in other indexes of anthropometry. Combining multi-micronutrient fortified biscuits with de-worming is an effective strategy.

Multi-micronutrient Fortified Beverage Delivered through the School-Based System Improved Iron Status and Test Scores of Children

“…Iron deficient children first enrolled in school were disadvantaged in terms of aptitudes, and this disappeared once they become iron-replete through supplementation [40]. Similar findings showed that multiple micronutrient fortified food was effective in improving micronutrient status and cognition [41,42], and vitamin and mineral deficiencies limit the child's optimal ability in cognition and intelligence [43]. In contrast, micronutrient supplementation during preschool years had no effect on aspects of intellectual, executive and motor function at 7-9 years old, suggesting no long-term developmental benefit during 12-35 months of age [44].…”

Species-Specific Associations Between Soil-Transmitted Helminths and Micronutrients in Vietnamese Schoolchildren

“…7 Only for Ascaris, significantly lower egg counts were observed after consumption of fortified biscuits combined with albendazole treatment, compared with albendazole alone. 33 Hemoglobin concentrations were lower in Trichuris, hookworm, and in children infected with multiple STH species than in those uninfected. Surprisingly, these infections were not associated with ferritin concentrations.…”

Improving Learning in Primary Schools of Developing Countries

“…Several studies did not report sufficient data to estimate the mean difference between treatment and control groups at each follow-up (Pollitt, Hathirat, Kotchabhakdi, Missell, & Valyasevi, 1989;Sungthong, Mo-suwan, Chongsuvivtwong, & Geater, 2004;Whaley et al, 2003), in one case because statistically nonsignificant results were not reported in the paper (Nga et al, 2011). In other cases, I could not convert mean differences (or a regression coefficient estimating a similar parameter) to effect sizes, given the lack of data on the standard deviation of the outcome variable (Adelman, Alderman, Gilligan, & Lehrer, 2008;Kazianga, de Walque, & Alderman, 2012;Pandey, Goyal, & Sundararaman, 2009;Vazir, Nagalla, Thangiah, Kamasamudram, & Bhattiprolu, 2006).…”