a1 International Emergency and Refugee Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, MS F-60, Atlanta, GA 30333, USA
a2 Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
a3 Centre for International Health and Development, Institute of Child Health, University College London, London, UK
a4 Maternal and Child Nutrition Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
a5 Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
a6 United Nations High Commissioner for Refugees, Laayoune, Western Sahara
a7 United Nations World Food Programme, Regional Bureau for Asia, Bangkok, Thailand
a8 United Nations High Commissioner for Refugees, Damascus, Syria
Objective To evaluate the effectiveness of stainless steel (Fe alloy) cooking pots in reducing Fe-deficiency anaemia in food aid-dependent populations.
Design Repeated cross-sectional surveys. Between December 2001 and January 2003, three surveys among children aged 6–59 months and their mothers were conducted in 110 households randomly selected from each camp. The primary outcomes were changes in Hb concentration and Fe status.
Setting Two long-term refugee camps in western Tanzania.
Subjects Children (6–59 months) and their mothers were surveyed at 0, 6 and 12 months post-intervention. Stainless steel pots were distributed to all households in Nduta camp (intervention); households in Mtendeli camp (control) continued to cook with aluminium or clay pots.
Results Among children, there was no change in Hb concentration at 1 year; however, Fe status was lower in the intervention camp than the control camp (serum transferrin receptor (sTfR) concentration: 6·8 v. 5·9 μg/ml; P < 0·001). There was no change in Hb concentration among non-pregnant mothers at 1 year. Subjects in the intervention camp had lower Fe status than those in the control camp (sTfR concentration: 5·8 v. 4·7 μg/ml; P = 0·003).
Conclusions Distribution of stainless steel pots did not increase Hb concentration or improve Fe status in children or their mothers. The use of stainless steel prevents rusting but may not provide sufficient amounts of Fe and strong educational campaigns may be required to maximize use. The distribution of stainless steel pots in refugee contexts is not recommended as a strategy to control Fe deficiency.
(Received February 13 2008)
(Accepted November 18 2008)
(Online publication April 01 2009)