Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Sep 3;14(9):e0221094.
doi: 10.1371/journal.pone.0221094. eCollection 2019.

Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: A systematic review

Clark Alves  1   2 , Ahlam Saleh  3 , Halimatou Alaofè  4
Affiliations
Meta-Analysis

Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: A systematic review

Clark Alves et al. PLoS One. .

Abstract

Background & objective: There is limited evidence regarding the efficacy of iron-containing pots and ingots in reducing iron deficiency (ID) and iron deficiency anemia (IDA) in low- and middle-income countries (LMICs). The objective of this systematic review is to summarize the evidence regarding the effect of iron-containing cookware on ID and IDA among children and females of reproductive age (FRA) in LMICs.

Methods: Searches were last conducted in May 2019 in PubMed, Embase, Cochrane Library, Web of Science, Scopus, CAB Abstracts, POPLINE, LILACS, ProQuest Dissertations & Theses Global, WHO ICTRP and ClinicalTrials.gov. Hand searching was also conducted. Selection criteria included randomized-controlled trials (RCTs), quasi-experimental studies and observational studies with control groups that studied the effect of iron-containing cookware in children (4 months-11 years) and females of reproductive age (12-51 years).

Results: Eleven studies were eligible for inclusion in the review. Statistically significant increases in hemoglobin and/or iron indices (p < 0.05) were observed in 50% (4/8) of studies on pots (relative change/mean difference in Hb: -0.4-1.20 g/dL), and 33.3% (1/3) of studies on ingots (relative change/mean difference in Hb: 0.32-1.18 g/dL). Positive outcomes (p < 0.05) were observed among children in 50% (4/8) of studies and among FRA in 28.6% (2/7) of studies. Compliance ranged from 26.7-71.4% daily use of pots to 90-93.9% daily use of ingots.

Conclusions: There are indications that, with reasonable compliance, iron-containing cookware could serve as a means of reducing IDA, especially among children. The potential advantages of iron-containing cookware include relative cost-effectiveness and complementary combination with other interventions. However, further research is needed regarding both the efficacy and safety of this intervention.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection process.
FRA: females of reproductive age.
See this image and copyright information in PMC

References

    1. Camaschella C. Iron-deficiency anemia. New England journal of medicine. 2015;372(19):1832–43. 10.1056/NEJMra1401038 - DOI - PubMed
    1. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. The Lancet. 2016;387(10021):907–16. - PubMed
    1. Kassebaum NJ, Collaborators GBDA. The Global Burden of Anemia. Hematol Oncol Clin North Am. 2016;30(2):247–308. Epub 2016/04/05. 10.1016/j.hoc.2015.11.002 . - DOI - PubMed
    1. Pasricha S-R, Drakesmith H, Black J, Hipgrave D, Biggs B-A. Control of iron deficiency anemia in low-and middle-income countries. Blood. 2013;121(14):2607–17. 10.1182/blood-2012-09-453522 - DOI - PubMed
    1. Friedman JF, Kanzaria HK, McGarvey ST. Human schistosomiasis and anemia: the relationship and potential mechanisms. Trends in parasitology. 2005;21(8):386–92. 10.1016/j.pt.2005.06.006 - DOI - PubMed