School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls

Tee, E‐Siong; Kandiah, Mirnalini; Awin, Narimah; Chong, Suet-Mei; Satgunasingam, N; Kamarudin, L; Milani, Silvano; Dugdale, A. E.; Viteri, Fernando E.

doi:10.1093/ajcn/69.6.1249

Cited by 76 publications

(67 citation statements)

References 5 publications

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“…Repeating the analysis among only those children who were dewormed or among only those not dewormed showed similar results as the analysis done for the two groups combined. Furthermore, the improvement in Hb concentration after the implementation of the school-based WISDS is consistent with the improvement in the Hb concentration in other school-based weekly iron supplementation studies that had a control group, in particular among schoolchildren in Mali (Hall et al, 2002) and among adolescent schoolgirls in Malaysia (Tee et al, 1999) and in Mozambique (Horjus et al, 2005).…”

Section: Discussionsupporting

confidence: 85%

“…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). The 60 mg dose seems to have had no adverse effects among schoolchildren in this study.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2007

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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.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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

et al. 2007

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“…Similar high compliance under programme conditions similar to our study was reported by Kotecha et al (5) in 2002 among rural and tribal adolescent girls of Gujarat. Like other authors (6,7) we used school teachers as supervisors for IFA supplementation as they can positively influence their students for compliance better than anybody else. Additionally, we used anganwadi workers as supervisors only to those adolescent girls who were not going to school and we also used standardized methods of compliance checking, i.e.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India

Chakma

Rao

Meshram

2012

Public Health Nutr.

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Objective: To study the feasibility of iron and folic acid (IFA) supplementation among tribal adolescent girls and identify factors associated with high compliance. Design: Intervention study with IFA supplementation among tribal adolescent girls of Bijadandi block, Mandla district, Madhya Pradesh, India. Girls (n 274) from twelve villages randomly selected out of 100 potential villages received daily tablets containing iron (III) hydroxide polymaltose complex equivalent to 100 mg of elemental Fe and 350 mg of folic acid (commercially available as Feritas tablets, marketed by Intas Pharmaceutical Ltd, India). IFA was given for 100 d and supervised by school teachers and anganwadi workers. Compliance was measured using cards and interviews. Setting: Community-based iron supplementation programme. Subjects: Tribal adolescent girls aged 12-19 years. Results: In total 233 girls completed the study. Prevalence of anaemia was reduced from 94 % at baseline to 69 % after the intervention. Compliance rate (.80 tablets) was 89 %. Minor side-effects were reported by three girls, yet they consumed .80 tablets. Factors associated with compliance included fasting during the local festival (x 2 5 72?74, df 3; P , 0?0001) and counselling (x 2 5 72?74, df 3; P , 0?0001). Other qualitative factors like social mobilization, timely supply of tablets, quality of tablets (blister pack) and availability of teachers and anganwadi workers were also associated with the compliance and feasibility. Conclusions: High compliance indicates that IFA supplementation with tablets is feasible among the tribal adolescent girls of Bijadandi block, Mandla district.

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“…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: 96%

The role of vitamins in the prevention and control of anaemia

Fishman

Christian

West

2000

Public Health Nutr.

264

208

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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.

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School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls

Abstract: Long-term, weekly iron-folate supplementation was found to be a practical, safe, effective, and inexpensive method for improving iron nutrition in adolescent schoolgirls.

Cited by 76 publications

References 5 publications

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

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

Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India

The role of vitamins in the prevention and control of anaemia

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