title: Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences.
abstract: Limited adherence to iron supplementation is thought to be a major reason for the low effectiveness of anemia-prevention programs. In rural Tanzania, women at 21-26 wk of gestation were randomly given either 120 mg of a conventional (Con) iron supplement or 50 mg of a gastric-delivery-system (GDS) iron supplement for 12 wk. Adherence was assessed by using a pill bottle equipped with an electronic counting device. Adherence in the GDS group was 61% compared with 42% for the Con group. In both groups, women experiencing side effects had about one-third lower adherence. Fewer side effects were observed in the GDS group. In a subgroup of women with a low initial hemoglobin concentration (< or = 120 g/L), the response to the iron supplements suggested that both of the applied doses were unnecessarily high for adequate hematologic response in a population with a marginal hemoglobin concentration. The GDS group appeared to require a dose one-fourth as high as that of the Con group for an equal effect on improving hemoglobin to normal concentrations.
authors.affiliation: Department of Epidemiology and Public Health, Umeå University, Sweden.
authors.forename: E C
authors.initials: EC
authors.lastname: Ekström
authors.forename: F P
authors.initials: FP
authors.lastname: Kavishe
authors.forename: J P
authors.initials: JP
authors.lastname: Habicht
authors.forename: E A
authors.initials: EA
authors.lastname: Frongillo
authors.forename: K M
authors.initials: KM
authors.lastname: Rasmussen
authors.forename: L
authors.initials: L
authors.lastname: Hemed
mesh_terms: D000740:Anemia / Q000517:prevention & control; D016503:Drug Delivery Systems; D005260:Female; D005527:Food, Fortified; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015999:Multivariate Analysis; D009994:Osmolar Concentration; D010349:Patient Compliance; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control; D011295:Prenatal Care; D013636:Tanzania
chemical_list: D006454:Hemoglobins; D007501:Iron