title: The effect on haemoglobin of the use of iron cooking pots in rural Malawian households in an area with high malaria prevalence: a randomized trial.
abstract: BACKGROUND
  Innovative low-cost sustainable strategies are required to reduce the high prevalence of iron-deficiency anaemia in developing countries.
  
  
  METHODS
  We undertook a community-based randomized controlled intervention trial to assess the effects of cooking in iron or aluminium cooking pots in Malawian households in an area with high malaria prevalence. Analysis was by intention to treat and consistency of use. The primary outcomes were change in haemoglobin and iron status.
  
  
  RESULTS
  The study population comprised 164 participants eating from aluminium cooking pots and 158 from iron cooking pots. The mean haemoglobin change was significantly increased after 6 weeks in adults who consistently ate from an iron cooking pot (+3.6 g/l compared to -3.2 g/l, mean difference between groups 6.8 g/l, 95% CI +0.86, +12.74). In children, no significant haemoglobin change was observed in consistent pot users, although they showed a significant reduction in iron deficiency (iron 8.6 ZP/g and aluminium 10.8 ZP/g, mean difference 2.2 ZP/g, 95% CI +1.08, +3.32).
  
  
  CONCLUSIONS
  Rural Malawian adults in a high malaria transmission area who consistently consume food prepared in iron cooking pots show a significant rise in haemoglobin after 6 weeks use. Children showed a reduction in iron deficiency, but no significant improvement in haemoglobin, possibly because of their high malaria parasite prevalence. Using iron cooking pots in developing countries could provide an innovative way to prevent iron deficiency and anaemia in malarious areas where regular iron supplementation is problematic.
authors.affiliation: Tropical Child Health Group, Division of Tropical Medicine, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Paul Prinsen
authors.initials: PP
authors.lastname: Geerligs
authors.forename: Bernard
authors.initials: B
authors.lastname: Brabin
authors.forename: Albert
authors.initials: A
authors.lastname: Mkumbwa
authors.forename: Robin
authors.initials: R
authors.lastname: Broadhead
authors.forename: Luis E
authors.initials: LE
authors.lastname: Cuevas
mesh_terms: D000293:Adolescent; D000328:Adult; D000535:Aluminum; D018798:Anemia, Iron-Deficiency / Q000517:prevention & control*; D002648:Child; D003297:Cooking and Eating Utensils; D003906:Developing Countries; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000008:administration & dosage*; D008288:Malaria / Q000097:blood*; D008295:Malawi; D008297:Male; D008875:Middle Aged; D012423:Rural Health
chemical_list: D006454:Hemoglobins; D000535:Aluminum; D007501:Iron