title: Effect on school attendance and performance of iron and multiple micronutrients as adjunct to drug treatment of Schistosoma-infected anemic schoolchildren.
abstract: BACKGROUND
  Relationships among Schistosoma haematobium, anemia, and iron deficiency have been documented, and all have been found to be associated with a decline in school attendance and lower performance.
  
  
  OBJECTIVE
  To assess the effect of single or combined iron and multiple micronutrients and/or praziquantel on school attendance and achievement in randomly selected 7- to 12-year-old anemic children with documented S. haematobium infection (n = 406) in Mali over a 3-month period.
  
  
  METHODS
  Schistosomiasis infection was diagnosed by the presence of schistosome eggs in the urine. Venous blood samples (5 mL) were drawn from an antecubital vein for hemoglobin assessment. Children were randomly assigned to one of four treatment groups: praziquantel alone, praziquantel + iron, praziquantel + multiple micronutrients, and praziquantel + multiple micronutrients + iron. School attendance was defined by the number of days the child was absent from class. Achievement was defined by the child's overall school grades.
  
  
  RESULTS
  Changes within treatment groups from baseline to the end of study were found for attendance (p < .001) but not for achievement (p > .05). Significant supplement treatments by age group interactions were found in 7- to 9-year-old children for attendance. Further exploration of treatment effects in this age group showed that only iron treatment's main effect was significant on attendance (p = .049) and was of borderline significance on school grades (p = .08).
  
  
  CONCLUSIONS
  Combined praziquantel and iron treatment improved children's school attendance and performance better than praziquantel alone, particularly among younger children.
authors: UNICEF Country Office, 125 Rue Faubert, Petionville, Port-au-Prince, Haiti. mayoya@unicef.org
authors: Mohamed Ag
authors: MA
authors: Ayoya
authors: Gerburg Maria
authors: GM
authors: Spiekermann-Brouwer
authors: Abdel Kader
authors: AK
authors: Traoré
authors: Cutberto
authors: C
authors: Garza
mesh_terms: D000041:Absenteeism; D000740:Anemia / Q000188:drug therapy*; D000818:Animals; D002648:Child; D019587:Dietary Supplements; D005260:Female; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects; D006801:Humans; D019266:Iron, Dietary / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008302:Mali / Q000453:epidemiology; D018977:Micronutrients / Q000627:therapeutic use*; D015999:Multivariate Analysis; D010270:Parasite Egg Count; D011223:Praziquantel / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012548:Schistosoma haematobium / Q000187:drug effects; D012553:Schistosomiasis haematobia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D012574:Schools
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary; D018977:Micronutrients; D011223:Praziquantel