Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions.
OBJECTIVE
Anemia is a major public health problem caused by multiple factors. Vitamin A (VA) depletion can affect hemoglobin concentration (Hb). This study investigated the improvement in Hb and VA status in preschool Indonesian children following supplementation with 210 micromol VA and deworming with 400 mg albendazole.


METHODS
Indonesian children (n = 131) infected with Ascaris lumbricoides and/or Trichuris trichiura were enrolled. The children were grouped by length of time since receiving 210 micromol VA through the local health system. Group 1 (VA administered > or = 4 month before baseline) included 51 children with Ascaris and 29 children with Trichuris. Group 2 had received VA < or = 1 month of baseline from the local health post and included 51 children.


METHODS
Immediately following baseline Hb and VA status assessment (modified relative dose response (MRDR) test), Group 1 children were given 210 micromol VA and 400 mg albendazole. Group 2 were randomized to be dewormed either 1 week before, at the same time or 1 week after baseline MRDR and Hb measures. Follow-up assessment was 3-4 weeks after baseline.


RESULTS
VA status in Group 1 significantly improved in children with either Ascaris (P < 0.0001) or Trichuris (P = 0.028). Although the prevalence of anemia declined, the improvement in Hb was not significant (P = 0.08). In Group 2, improvement in VA status from the VA delivered through the public health system was maintained for more than 1 month. Hb improved (P = 0.0037) and this improvement appeared to be associated with the length of time between deworming and follow-up assessments.


CONCLUSIONS
Public health supplementation programs to improve VA status may also increase Hb concentrations and decrease anemia prevalence, especially when linked to deworming.


BACKGROUND
These studies were supported by the Thrasher Research Fund, SmithKline Beecham and Hatch-Wisconsin Agricultural Experiment Station number WIS04533.
Tanumihardjo
S A
SA
Department of Nutritional Sciences, UW-Madison, Madison, WI 53706, USA. sherry@nutrisci.wisc.edu
Permaesih
D
D
Muhilal
D015766:Albendazole / Q000627:therapeutic use*; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D001196:Ascariasis / Q000188:drug therapy; D017164:Ascaris lumbricoides; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007214:Indonesia; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009752:Nutritional Status; D014257:Trichuriasis / Q000188:drug therapy; D014801:Vitamin A / Q000008:administration & dosage*
D000871:Anthelmintics; D006454:Hemoglobins; D014801:Vitamin A; D015766:Albendazole