Iron Deficiency Alleviation in Developing Countries

Schultink, Werner; Gross, Rainer

doi:10.1079/nrr19960015

Cited by 25 publications

(15 citation statements)

References 62 publications

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“…The ®ndings of the present study have important implications on the iron supplementation programmes. Frequently the effectiveness of the programmes is found to be poor, which has become a major concern (UNACCaSCN, 1991;Schultink and Gross, 1996). Our data reinforce the suggestion that programmes designed to reduce anaemia should also aim to improve vitamin A status (Bloem, 1995).…”

Section: Discussionsupporting

confidence: 67%

Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh

et al. 2000

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Objective: To investigate the prevalence of anaemia and iron de®ciency among adolescent schoolgirls in periurban Bangladesh, and to identify various factors associated with anaemia in this population. Design: A cross-sectional design. Setting: Girls' high schools in ®ve sub-districts of Dhaka. Subjects: Adolescent girls (n 548) aged 11 ± 16 y from nine schools in Dhaka district participated in the study. Socio-economic, anthropometric and dietary information were collected. Blood haemoglobin (Hb), serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF) and serum retinol (vitamin A) were determined. Results: The prevalence of anaemia (Hb`120 gal) among the participants was 27%. Seventeen percent had depleted iron stores (SF`12 mgal). Of all anaemic girls, 32% had iron de®ciency anaemia (Hb`120 gal and SF`12 mgal). When the girls were classi®ed by serum vitamin A, the third with the lowest serum retinol levels had signi®cantly lower Hb and SF levels. Signi®cant positive correlations were observed between Hb and serum iron, TS, SF and retinol, while there was a negative correlation with serum TIBC. Occupancy, frequency of consumption of large ®sh, serum iron, TIBC, TS, SF and serum vitamin A were strongly related to Hb by multiple regression analysis. For 1 mgal change in SF concentration, there was a 0.046 gal change in Hb, when adjusted for all other factors. Conclusion: Anaemia among these adolescent schoolgirls in peri-urban Bangladesh cannot be explained by iron de®ciency alone, and other causes may also exist in this population. Descriptors: iron de®ciency; anaemia; adolescent girls; serum ferritin; serum vitamin A

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Section: Discussionsupporting

confidence: 67%

Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh

et al. 2000

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“…With large-scale supplementation programs, however, factors such as the cost, availability, and distribution of supplements and Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children compliance with prescribed supplement intake often reduce the programs' effectiveness, as experienced with iron supplementation programs for pregnant women (11,12). Therefore, alternatives to currently used supplementation strategies need to be investigated to raise effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children

Thu

Schultink

Dillon

et al. 1999

The American Journal of Clinical Nutrition

116

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Background: Micronutrient deficiencies remain common in preschool children in developing countries. Interventions focus on single micronutrients and often lack effectiveness. Weekly instead of daily supplementation may improve effectiveness. Objective: The efficacy of weekly and daily supplementation in reducing anemia prevalence and in improving the zinc, vitamin A, and growth status of 6-24-mo-old Vietnamese children was investigated. Design: In this double-blind, placebo-controlled trial, the daily group (n = 55) received 8 mg elemental Fe (as iron sulfate), 5 mg elemental Zn (as zinc sulfate), 333 g retinol, and 20 mg vitamin C 5 d/wk for 3 mo. The weekly group (n = 54) received 20 mg Fe, 17 mg Zn, 1700 g retinol, and 20 mg vitamin C once a week. A third group (n = 54) received a placebo only. Venous blood samples were collected at the start and end of the supplementation period and anthropometric measurements were taken at the start and 3 mo after the end of supplementation. Results: At baseline, 45.6% of subjects had hemoglobin concentrations < 110 g/L, 36.3% had zinc concentrations < 10.71 mol/L, and 45.6% had retinol concentrations < 0.70 mol/L. Hemoglobin, retinol, and zinc concentrations of both the weekly and daily groups increased similarly compared with the placebo group (P < 0.001). There was no significant difference in growth between the supplemented groups and the placebo group. However, the height-for-age of subjects stunted at baseline increased with z scores of 0.48 (P < 0.001) and 0.37 (P < 0.001) for the daily and weekly groups, respectively. Conclusions: Weekly and daily supplementation improved hemoglobin, zinc, and retinol concentrations similarly. Neither intervention affected growth of the overall population, but growth of children stunted at baseline was improved through both types of supplementation.Am J Clin Nutr 1999;69:80-6.

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“…The primary proponents of the intermittent approach have a historical view based on their, and others, frustrations with the lack of effectiveness of daily iron intervention in developing countries (12)(13)(14). That is, compliance is low with many daily supplementation programs and there is a strong need to improve the coverage of at-risk populations when human and financial resources are limited (12).…”

mentioning

confidence: 99%

“…This is not the first review of published scientific literature on this topic (13,(20)(21)(22)(23). Several full-length research reports on randomized clinical intervention field trials from around the world can be found in the published literature (24)(25)(26)(27)(28)(29)(30).…”

mentioning

confidence: 99%

“…These reports come from research groups centered in China (30); Jakarta, Indonesia (26-31); and Bolivia (25) Weekly iron intervention: the case for intermittent iron supplementation 1,2 in peer-reviewed scientific journals and were not considered in this review. The commentaries referred to above (13,(20)(21)(22)(23) have already critiqued the strengths and weaknesses of both sides of the debate and the concerns cited involve research design, dosage, duration of intervention, and other specific points for the field trials. In addition, there are concerns about the laboratory studies regarding small sample sizes, limited replication, and interpretation of single-meal radioiron absorption data.…”

mentioning

confidence: 99%

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