Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area.
OBJECTIVE
To study impact of once weekly iron supplementation on praziquantel cure rate, Schistosoma haematobium reinfection, and haematological parameters in pupils aged between 9 and 15 years of age in Nchelenge district, Zambia.


METHODS
Pupils in the intervention group received once weekly dose of ferrous sulphate at 200 mg while those in the control received once weekly vitamin C at 100 mg for up to 9 months. Both study groups received a single dose of praziquantel at baseline.


RESULTS
S haematobium reinfection intensity was significantly lower in boys in the intervention group than in boys in the control group at 6 months (P < 0.001) and 9 months (P < 0.001) of supplementation. Significantly lower S haematobium reinfection intensity was found in girls in the intervention group than in girls in the control group only at 6 months of supplementation (P = 0.018). Boys in the intervention group were 42% (Adjusted Risk Ratio = 0.58, 95% confidence interval 0.39, 0.86) less likely to be reinfected with S haematobium than in the control group at 6 months follow up.


CONCLUSIONS
Once weekly iron supplementation can decrease S haematobium reinfection after 6 months and should be incorporated into school based schistosomiasis control programs in highly endemic areas.
Mwanakasale
Victor
V
Tropical Diseases Research Centre, P.O. Box 71769, Ndola, Zambia. MwanakasaleV@tdrc.org.zm
Siziya
Seter
S
Mwansa
James
J
Koukounari
Artemis
A
Fenwick
Alan
A
D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D000871:Anthelmintics / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D019587:Dietary Supplements; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D011223:Praziquantel / Q000627:therapeutic use; D012553:Schistosomiasis haematobia / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D012572:School Health Services; D015024:Zambia
D000871:Anthelmintics; D005296:Ferrous Compounds; D006454:Hemoglobins; C020748:ferrous sulfate; D011223:Praziquantel