Effectiveness of weekly vitamin A (10,000 IU) and iron (60 mg) supplementation for adolescent boys and girls through schools in rural and urban East Java, Indonesia.
OBJECTIVE
High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions. This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status.


METHODS
School-based, grade-randomized, intervention.


METHODS
In all, 1757 girls and 1859 boys, aged 12-15 y, in 24 Junior High Schools.


METHODS
Weekly supplementation for 14 weeks with 60 mg iron and 250 microg folate (Fe group; n=978), 10 000 IU vitamin A (VA group; n=970) or both (VAFe group; n=1042) to subjects in 15 schools, compared to subjects in nine other schools not receiving supplements (control; n=626).


RESULTS
The baseline anaemia prevalence (Hb <120 g/l) in girls was 20% (prepubertal) and 26% (pubertal), and in boys 24% (pre-pubertal) and 11% (pubertal). Serum retinol concentrations were low (<1.05 micromol/l) in 41% of boys and 45% of girls. The interventions did not increase haemoglobin concentrations. Serum retinol concentration of boys, but not girls, in the VA group increased (0.33 vs 0.07 micromol/l in controls; P<0.01). The risk factors for low serum retinol concentration were lower baseline serum retinol concentration (OR 0.02-0.03) with, for girls, nightblindness at baseline (OR 5.88), and for boys, not receiving vitamin A (OR control: 1.00; VA: 0.37; Fe: 0.77; VAFe: 0.34) and maternal illiteracy (OR mother never attended school 1.00, mother received any formal education 0.17-0.33).


CONCLUSIONS
Supplementation with vitamin A increased serum retinol concentration of boys. Iron supplementation did not change Hb. This appeared to be due to poor compliance, and partly related to side effects.
Soekarjo
D D
DD
Helen Keller International Indonesia, Jakarta, Indonesia. ddsoekarjo@hkiasiapacific.org
Pee Sd
S de
Sd
Kusin
J A
JA
Schreurs
W H P
WH
Schultink
W
W
Muhilal
Bloem
M W
MW
D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D019266:Iron, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D012423:Rural Health; D016896:Treatment Outcome; D014504:Urban Health; D014801:Vitamin A / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control
D019266:Iron, Dietary; D014801:Vitamin A; D005492:Folic Acid