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Controlled Clinical Trial
. 2009 Mar;21(1):12-8.
doi: 10.4314/mmj.v21i1.10982.

Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area

Victor Mwanakasale  1 , Seter Siziya, James Mwansa, Artemis Koukounari, Alan Fenwick
Affiliations
Controlled Clinical Trial

Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area

Victor Mwanakasale et al. Malawi Med J. 2009 Mar.

Abstract

Aim: To study impact of once weekly iron supplementation on praziquantel cure rate, Schistosoma haematobium reinfection, and haematological parameters in pupils aged between 9 and 15 years of age in Nchelenge district, Zambia.

Methods: Pupils in the intervention group received once weekly dose of ferrous sulphate at 200 mg while those in the control received once weekly vitamin C at 100 mg for up to 9 months. Both study groups received a single dose of praziquantel at baseline.

Results: S haematobium reinfection intensity was significantly lower in boys in the intervention group than in boys in the control group at 6 months (P < 0.001) and 9 months (P < 0.001) of supplementation. Significantly lower S haematobium reinfection intensity was found in girls in the intervention group than in girls in the control group only at 6 months of supplementation (P = 0.018). Boys in the intervention group were 42% (Adjusted Risk Ratio = 0.58, 95% confidence interval 0.39, 0.86) less likely to be reinfected with S haematobium than in the control group at 6 months follow up.

Conclusion: Once weekly iron supplementation can decrease S haematobium reinfection after 6 months and should be incorporated into school based schistosomiasis control programs in highly endemic areas.

Trial registration: ClinicalTrials.gov NCT00276224.

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Figures

Figure 1
Figure 1
S. haematobium infection at baseline, post treatment residual infection at 3 months, and reinfection at 6 and 9 months
Figure 2
Figure 2
S. haematobium intensity (geometric mean) of infection at baseline and 3 months and reinfection at 6 and 9 months follow ups
Figure 3
Figure 3
Mean haemoglobin levels at baseline and 9 months follow up
Figure 4
Figure 4
Mean number of doses of iron/placebo received by each follow up time
See this image and copyright information in PMC

References

    1. Partnership for Child Development, author. Iron deficiency anaemia. 2004. Available from URL: http://www.schoolsandhealth.org.
    1. Asobayire F S, Adou P, Davidsson L, Cook JD, Hurrell RF. Prevalence of iron deficiency with and without concurrent anaemia in population groups with high prevalence of malaria and other infections: a study in Cote d'Ivoire. American Journal of Clinical Nutrition. 2001;74:776–782. - PubMed
    1. Van den Broek NR, Letsky EA. Aetiology of anaemia in pregnancy in South Malawi. American Journal of Clinical Nutrition. 2000;72:247S–256S. - PubMed
    1. Centers for Disease Control and Prevention, author. Recommendations to prevent and control iron deficiency in the United States. Morbidity and mortality Weekly Report 47. 1998 - PubMed
    1. World Health Organisation, author. Focusing on anaemia: towards an integrated approach for effective anaemia control. 2004. Joint statement by WHO and UNICEF.

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