title: Long-term weekly iron-folic acid and de-worming is associated with stabilised haemoglobin and increasing iron stores in non-pregnant women in Vietnam.
abstract: BACKGROUND
  The prevalence of anaemia and iron deficiency in women remains high worldwide. WHO recommends weekly iron-folic acid supplementation where anaemia rates in non-pregnant women of reproductive age are higher than 20%. In 2006, a demonstration project consisting of weekly iron-folic acid supplementation and regular de-worming was set up in two districts in a northern province in Vietnam where anaemia and hookworm rates were 38% and 76% respectively. In 2008 the project was expanded to all districts in the province, targeting some 250,000 women. The objectives of this study were to: 1) examine changes in haemoglobin, iron stores and soil transmitted helminth infection prevalence over three years and 2) assess women's access to and compliance with the intervention.
  
  
  RESULTS
  The study was a semi-cross-sectional, semi-longitudinal panel design with a baseline survey, three impact surveys at three-, twelve- and thirty months after commencement of the intervention, and three compliance surveys after ten weeks, eighteen and thirty six months.
  
  
  RESULTS
  After thirty months, mean haemoglobin stabilised at 130.3 g/L, an increase of 8.2 g/L from baseline, and mean serum ferritin rose from 23.9 µg/L to 52 µg/L. Hookworm prevalence fell from 76% to 22% over the same period. After thirty six months, 81% of the target population were receiving supplements and 87% were taking 75% or more of the supplements they received.
  
  
  CONCLUSIONS
  Weekly iron-folic acid supplementation and regular de-worming was effective in significantly and sustainably reducing the prevalence of anaemia and soil transmitted helminth infections and high compliance rates were maintained over three years.
authors.affiliation: Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Casey
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
authors.forename: Tran Q
authors.initials: TQ
authors.lastname: Phuc
authors.forename: Ta T
authors.initials: TT
authors.lastname: Tinh
authors.forename: Dang H
authors.initials: DH
authors.lastname: Tho
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.forename: Beverley-Ann
authors.initials: BA
authors.lastname: Biggs
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000378:metabolism*; D006454:Hemoglobins / Q000378:metabolism*; D006725:Hookworm Infections / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008137:Longitudinal Studies; D008875:Middle Aged; D012424:Rural Population; D012987:Soil; D014744:Vietnam
chemical_list: D006454:Hemoglobins; D012987:Soil; D005492:Folic Acid; D007501:Iron