title: Effectiveness of routine antihelminthic treatment on anaemia in pregnancy in Rufiji District, Tanzania: a cluster randomised controlled trial.
abstract: OBJECTIVE
  The aim of this study was to estimate the effect of an antihelminthic drug, given at booking and at term to antenatal care visits, on the prevalence of anaemia at term and 4 months post-partum in Rufiji district, Tanzania, the area with high prevalence of intestinal parasites.
  
  
  METHODS
  A cluster randomised controlled trial was conducted on 3080 pregnant women. Out of these 1475 (study arm) received albendazole and 1605 (control arm) placebo. All women also received routine daily iron folate supplements (36 mg iron and 5 mg folate), and sulphadoxine pyramethamine (SP) to prevent malaria. Haemoglobin levels were assessed at booking, at term and 4 months post-partum.
  
  
  RESULTS
  At term, median and mean haemoglobin level and the prevalence of severe (< 70 g/l) and moderate (70-104 g/l) anaemia did not differ. The reduction in the prevalence of anaemia from booking to term, was significantly larger in the study arm compared to control arm (26.1% vs. 18.8%; p < 0.001). At four months postpartum, mean haemoglobin was higher in the study arm compared to the control arm (118 vs. 113; p < 0.0001) while the reduction in proportion of women with anaemia (Hb <105 g/dl) was significantly lower (30.6 vs. 21.2; p < 0.0001) in the study arm compared to the control arm.
  
  
  CONCLUSIONS
  These findings support WHO's recommendation for anthelmintic treatment during pregnancy. However benefits for deworming may be limited in areas with an antenatal iron supplementation programme or low intensity of hookworm infections and hence future research should be directed towards the cost-effectiveness of the de-worming compared to other interventions for reducing anaemia in pregnancy.
authors.affiliation: Department of Commnunity Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. durassa@muhas.ac.tz
authors.forename: David P
authors.initials: DP
authors.lastname: Urassa
authors.forename: Lennarth
authors.initials: L
authors.lastname: Nystrom
authors.forename: Anders
authors.initials: A
authors.lastname: Carlsted
mesh_terms: D000328:Adult; D015766:Albendazole / Q000008:administration & dosage*; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000517:prevention & control; D000871:Anthelmintics / Q000008:administration & dosage*; D000962:Antimalarials / Q000008:administration & dosage; D016000:Cluster Analysis; D004338:Drug Combinations; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005500:Follow-Up Studies; D005865:Gestational Age; D006373:Helminthiasis / Q000097:blood / Q000517:prevention & control*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D008288:Malaria / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000517:prevention & control; D015597:Pregnancy Complications, Parasitic / Q000097:blood / Q000517:prevention & control*; D011295:Prenatal Care; D015995:Prevalence; D011739:Pyrimethamine / Q000008:administration & dosage; D016037:Single-Blind Method; D013413:Sulfadoxine / Q000008:administration & dosage; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000962:Antimalarials; D004338:Drug Combinations; D006454:Hemoglobins; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D005492:Folic Acid; D007501:Iron; D015766:Albendazole; D011739:Pyrimethamine