title: Impact of Cowpea-Based Food Containing Fish Meal Served With Vitamin C-Rich Drink on Iron Stores and Hemoglobin Concentrations in Ghanaian Schoolchildren in a Malaria Endemic Area.
abstract: BACKGROUND
  Nutritional anemia is a public health problem among Ghanaian schoolchildren. There is need to employ dietary modification strategies to solve this problem through school and household feeding programs.
  
  
  OBJECTIVE
  To evaluate the effectiveness of cowpea-based food containing fish meal served with vitamin C-rich drink to improve iron stores and hemoglobin concentrations in Ghanaian schoolchildren.
  
  
  METHODS
  The study involved cross-sectional baseline and nutrition intervention phases. There were 150 participants of age 6 to 12 years. They were randomly assigned to 3 groups, fish meal -vitamin C (n = 50), vitamin C (n = 50), and control (n = 50), and given different cowpea-based diets for a 6-month period. Height and weight measurements were done according to the standard procedures, dietary data were obtained by 24-hour recall and food frequency questionnaire, hemoglobin concentrations were determined by Hemocue Hemoglobinometer, and serum ferritin and complement-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay. Participants' blood samples were examined for malaria parasitemia and stools for helminthes using Giemsa stain and Kato-Katz techniques, respectively.
  
  
  RESULTS
  Mean ferritin concentration was not significantly different among groups. End line mean or change in hemoglobin concentrations between fish meal-vitamin C group (128.4 ± 7.2/8.3 ± 10.6 g/L) and control (123.1 ± 6.6/4.2 ± 10.4 g/L) were different, P < .05. Change in prevalence of anemia in fish meal-vitamin C group (19.5%) was different compared to those of vitamin C group (9.3%) and the control (12.2%). Levels of malaria parasitemia and high CRP among study participants at baseline and end line were 58% and 80% then 55% and 79%, respectively. Level of hookworm infestation was 13%.
  
  
  CONCLUSIONS
  Cowpea-based food containing 3% fish meal and served with vitamin C-rich drink improved hemoglobin concentration and minimized the prevalence of anemia among the study participants.
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana gegbi@noguchi.ug.edu.gh.
authors.forename: Godfred
authors.initials: G
authors.lastname: Egbi
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
authors.forename: Irene
authors.initials: I
authors.lastname: Ayi
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
authors.forename: Firibu Kwesi
authors.initials: FK
authors.lastname: Saalia
authors.affiliation: University of Health & Allied Sciences, Ho, Ghana.
authors.forename: Francis
authors.initials: F
authors.lastname: Zotor
authors.affiliation: Ghana Atomic Energy Commission, Legon, Accra, Ghana.
authors.forename: Theodosia
authors.initials: T
authors.lastname: Adom
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
authors.forename: Eric
authors.initials: E
authors.lastname: Harrison
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
authors.forename: Collins K
authors.initials: CK
authors.lastname: Ahorlu
authors.affiliation: Department of Nutrition, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
authors.forename: Matilda
authors.initials: M
authors.lastname: Steiner-Asiedu
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000517:prevention & control*; D000818:Animals; D001205:Ascorbic Acid / Q000008:administration & dosage; D001628:Beverages; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D005399:Fishes; D005527:Food, Fortified; D005869:Ghana / Q000453:epidemiology; D006454:Hemoglobins; D006801:Humans; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D012572:School Health Services; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014675:Vegetables
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein; D005293:Ferritins; D001205:Ascorbic Acid
keywords: Ghanaian schoolchildren; anemia; cowpea; fish meal; hemoglobin; iron stores; vitamin C–rich drink