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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Effects on haemoglobin of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomized,
1Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark. hfr@kvl.dk
Insights
Multi-micronutrient supplementation and anthelmintic treatment significantly improved hemoglobin levels in Kenyan schoolchildren. These interventions were effective regardless of initial hemoglobin or nutritional status, highlighting their potential for public health initiatives.
Area of Science:
- Public Health Nutrition
- Infectious Diseases
- Pediatric Health
Background:
- Iron deficiency anemia and helminth infections are prevalent in school-aged children, impacting cognitive development and overall health.
- Schools offer a viable platform for delivering health interventions to large child populations.
Purpose of the Study:
- To evaluate the impact of multi-micronutrient supplementation and multi-helminth chemotherapy on hemoglobin concentration in school children.
- To assess the efficacy of school-based health delivery systems for these interventions.
Main Methods:
- A randomized, placebo-controlled, double-blind, two-by-two factorial trial was conducted.
- Participants received either multi-micronutrient supplements or a placebo, and anthelmintic treatment (albendazole and praziquantel) or a placebo.
- Hemoglobin levels were measured at baseline and after 8 months.
Main Results:
- Both multi-micronutrient supplementation and anthelmintic treatment independently increased hemoglobin levels (P=0.0002 and P=0.03, respectively).
- Treatment effects were independent of baseline hemoglobin and nutritional status.
- Anthelmintic treatment efficacy was linked to reduced Schistosoma mansoni and hookworm infection intensity.
Conclusions:
- Multi-micronutrient supplementation and multi-helminth chemotherapy are effective in increasing hemoglobin concentration among school children.
- School-based delivery systems can successfully implement these public health interventions.
Objective:
To assess the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on haemoglobin concentration (Hb), using schools as a health delivery system. STUDY AREA AND POPULATION: Nine hundred seventy-seven children between 9 and 18 y of age from 19 primary schools in Bondo District, western Kenya, were included in the trial. The 746 (76.4%) children on whom baseline Hb was available were included in this study.
Design:
The study was a randomized, placebo-controlled, double-blind, two-by-two factorial trial of the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on Hb after 8 months.
Intervention:
Single treatment of infected children with albendazole (600 mg) for geohelminths and praziquantel (40 mg/kg) for Schistosoma mansoni and daily supplementation with 13 micronutrients.
Results:
: Multi-micronutrient supplementation (3.5 g/l, 95% CI 1.7, 5.3; P=0.0002) and anthelminthic treatment (2.0 g/l, 95% CI 0.2, 3.9; P=0.03) increased Hb independently (interaction, P=0.33). The effects were also independent of baseline Hb and general nutritional status. The treatment effect was due to reductions in S. mansoni and hookworm intensities of infection, in that Hb increased by 0.4 and 0.2 g/l, respectively, per 100 epg reductions in egg output. Interestingly, among S. mansoni-infected children, the effect of treatment seemed stronger in those with compared to those without co-existing malaria parasitaemia (interaction, P=0.09).
Conclusion:
Multi-micronutrient supplementation and multi-helminth chemotherapy increased Hb among school children, irrespective of initial Hb and nutritional status.
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