Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children.
OBJECTIVE
To assess the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on serum retinol concentration, using schools as a health delivery system. STUDY AREA AND POPULATION: From 19 primary schools in Bondo District, western Kenya, 977 children between 9 and 18 y were included in the trial. The 644 (65.9%) children on whom baseline serum retinol was available were included in this study.


METHODS
A randomised, placebo-controlled, double-blind, two-by-two factorial trial on the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on serum retinol after 8 months.


METHODS
Single treatment with albendazole (600 mg) and praziquantel (40 mg/kg of body weight) and daily multi-micronutrient supplementation with tablet containing 1000 microg vitamin A.


RESULTS
Micronutrient supplementation (0.08 micromol/l, 95% CI 0.01, 0.14; P=0.025), but not treatment (0.03 micromol/l, 95% CI -0.04, 0.10; P=0.38), increased serum retinol. However, treatment did increase serum retinol in S. mansoni-infected (0.09, 95% CI 0.02, 0.16; P=0.009), but not in uninfected children (-0.07, 95% CI -0.18, 0.03; P=0.18; interaction, P=0.01). Similarly, reduction in egg output of S. mansoni, but none of the geohelminth, was a predictor, corresponding to a 0.008 micromol/l (95% CI 0.00002, 0.02; P=0.049) increase in serum retinol per 100 epg reduction. Interestingly, interactions were found between age and sex (P=0.046), and malaria parasitaemia and sickle cell phenotype (P=0.04).


CONCLUSIONS
Multi-micronutrient supplementation and reduction in S. mansoni egg output increased serum retinol, irrespective of initial serum retinol.


BACKGROUND
The Danish International Development Assistance.
Mwaniki
D
D
Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Omondi
B
B
Muniu
E
E
Thiong'o
F
F
Ouma
J
J
Magnussen
P
P
Geissler
P W
PW
Michaelsen
K F
KF
Friis
H
H
D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000494:pharmacology*; D002648:Child; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006373:Helminthiasis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006376:Helminths / Q000187:drug effects; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007630:Kenya; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000627:therapeutic use; D010270:Parasite Egg Count; D018512:Parasitemia / Q000150:complications; D012550:Schistosoma mansoni; D012621:Seasons; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood*; D014802:Vitamin A Deficiency / Q000188:drug therapy*
D000871:Anthelmintics; D018977:Micronutrients; D014801:Vitamin A