American Journal of Tropical Medicine and Hygiene
Volume 64, Issue 3-4, 2001, Pages 164-171

Randomized intervention study comparing several regimens for the treatment of moderate anemia among refugee children in kigoma region, Tanzania (Article)

Tomashek K.M. , Woodruff B.A.* , Gotway C.A. , Bloland P. , Mbaruku G.
  • a Intl. Emergency/Refugee Hlth. Br., Centers for Dis. Ctrl. and Prev., Mailstop F48, 4770 Buford Highway NE, Atlanta, GA 30341, United States
  • b Intl. Emergency/Refugee Hlth. Br., Centers for Dis. Ctrl. and Prev., Mailstop F48, 4770 Buford Highway NE, Atlanta, GA 30341, United States
  • c Intl. Emergency/Refugee Hlth. Br., Centers for Dis. Ctrl. and Prev., Mailstop F48, 4770 Buford Highway NE, Atlanta, GA 30341, United States
  • d Intl. Emergency/Refugee Hlth. Br., Centers for Dis. Ctrl. and Prev., Mailstop F48, 4770 Buford Highway NE, Atlanta, GA 30341, United States
  • e Intl. Emergency/Refugee Hlth. Br., Centers for Dis. Ctrl. and Prev., Mailstop F48, 4770 Buford Highway NE, Atlanta, GA 30341, United States

Abstract

Anemia-specific mortality was markedly elevated among refugee children < 5 years of age in Tanzania. In a randomized, double-blind study, 215 anemic children were initially treated for malaria and helminth infection and then received 12 weeks of thrice-weekly oral iron and folic acid. Group I received placebo and chloroquine treatment for symptomatic malaria infection (i.e., no presumptive anti-malarial treatment given). Group II received placebo and monthly presumptive treatment with sulfamethoxazole-pyrimethamine (SP). Group III also received monthly SP and thrice-weekly vitamins A and C (VAC). Mean hemoglobin concentration increased from 6.6 to 10.2 g/dL, with no significant differences among groups. Group II had lower mean serum transferrin receptor levels (TfR) than group I [P = 0.023]. A greater proportion of participants in group III had normal iron stores (TfR < 8.5 μg/ mL) than in group II [P = 0.012]. Initial helminth and malaria treatment, followed by thrice-weekly iron and folic acid supplements resulted in increased hemoglobin levels. Monthly SP and thrice-weekly VAC contributed to improve iron stores. Monthly SP may have a role in situations where asymptomatic disease is prevalent or where access to care is limited. Because administration of VAC also hastened recovery of iron stores over administration of monthly SP alone, health care personnel could add VAC to the treatment for moderate anemia if maximum recovery of iron stores is desired.

Author Keywords

[No Keywords available]

Index Keywords

pyrimethamine refugee controlled clinical trial Vitamin A sulfamethoxazole clinical trial human double blind procedure Refugees controlled study Malaria blood smear ascorbic acid randomized controlled trial hemoglobin determination Drug Administration Schedule Humans anemia Anemia, Iron-Deficiency mebendazole Severity of Illness Index Antimalarials male antimalarial agent female iron deficiency Infant Child, Preschool retinol Double-Blind Method Article major clinical study Tanzania helminthiasis folic acid iron storage fansidar Iron, Dietary ferrous sulfate transferrin receptor chloroquine Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0034977976&partnerID=40&md5=9fe171b6617dd36161e5f56942e2f7bb
ISSN: 00029637
Cited by: 27
Original Language: English