British Journal of Nutrition

Full Papers

The effect of iron fortification and de-worming on anaemia and iron status of Vietnamese schoolchildren

Huong Thi Lea1 c1, Inge D. Brouwera2, Khan Cong Nguyena3, Jan Buremaa2 and Frans J. Koka2

a1 The Nutrition Department, Hanoi Medical University, No. 1 Ton That Tung Str., Dongda, Hanoi, Viet Nam

a2 The Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands

a3 The National Institute of Nutrition, No. 48B Tang Bat Ho Str., Hanoi, Viet Nam

Abstract

Previous data from Vietnam show that anaemia is highly prevalent among schoolchildren, who are considered not to be iron deficient. Trichuris infection doubled the risk of anaemia. The present study aimed to evaluate the hypothesis that de-worming is more effective than iron fortification in an anaemic, infection-prone population. In a trial with a 2 × 2 factorial design, 425 anaemic children aged 6–8 years were randomly assigned to receive either iron-fortified noodles or placebo, and mebendazole or placebo. Outcomes considered were change in haematological indicators of iron status (Hb, serum ferritin (SF), serum transferrin receptor (TfR) and haemoglobinopathies analysis); inflammations (C-reactive protein (CRP)); parasite infection status (hookworm, Trichuris and Ascaris infection); and IgE. ANOVA and logistic regression were used to assess the effects of iron fortification and de-worming on Hb, SF, TfR, body iron and anaemia. Hb improved in all groups after 6 months of intervention. Iron fortification significantly improved Hb, SF and body iron (2·6 g/l, 16·3 μg/l and 1 mg/kg, respectively). Prevalence of elevated IgE was very high at baseline (99 %) and significantly reduced to about 75 % in all groups after intervention. De-worming unexpectedly showed no effect on Hb, iron status and IgE level. It is concluded that iron fortification slightly improved anaemia and iron status in anaemic schoolchildren in rural Vietnam that were not considered iron deficient. Chronic infection or other unidentified factors may play an important role in the seasonal reduction of anaemia seen in all treatment groups.

(Received June 28 2006)

(Revised November 15 2006)

(Accepted November 20 2006)

Correspondence:

c1 *Corresponding author: Mrs Huong Thi Le, No. 41 Lane 101, Pham Ngoc Thach Str., Dongda, Hanoi, Vietnam, fax +84 4 7337955, email huong.lethi@wur.nl or email donghuong@fpt.vn

Footnotes

Abbreviations: CRP, C-reactive protein; MEB, mebendazole; SF, serum ferritin; TfR, serum transferrin receptor