Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Eur J Clin Nutr. 2013 Nov;67(11):1188-92. doi: 10.1038/ejcn.2013.160. Epub 2013 Sep 11.
BACKGROUND/OBJECTIVE: To assess the effectiveness of iron supplements administered to school children through a longitudinal school health intervention in terms of child haemoglobin concentration and anaemia prevalence.
SUBJECTS/METHODS: Children and adolescents aged 5-17 years were selected from 30 schools in north-west Pakistan for a longitudinal iron supplement intervention. Children received once-weekly iron supplements (200 mg ferrous sulphate containing 63 mg of elemental iron) for 24 weeks (n=352); or the same supplements twice-weekly for 12 weeks (n=298) or received no tablets (n=298). Haemoglobin concentration was estimated in finger-prick blood samples at baseline, 12 and 24 weeks. Follow-up samples were taken at 36 weeks.
A non-significant increase in haemoglobin concentration was observed in children receiving iron supplements after 12 weeks (mean 1.4 g/l s.d. 15.0 g/l in once-weekly versus 2.5 g/l s.d. 14.5 g/l in twice-weekly) compared with the group receiving no iron supplements. There was no significant reduction in the prevalence of anaemia in the once-weekly or twice-weekly group compared with the unsupplemented group. The prevalence of anaemia increased in all three groups during the follow-up period (24-36 weeks).
Once-weekly and twice-weekly iron supplements were not associated with significant increases in haemoglobin concentration compared with unsupplemented children. In all groups, baseline haemoglobin concentration was the strongest predictor of haemoglobin increase. The lack of improvement may stem from the moderate baseline prevalence of anaemia (33%); other micronutrient deficiencies; variable compliance; or the worsening of haemoglobin status owing to seasonal changes in dietary iron and other nutrients.
背景/目的：通过纵向学校卫生干预，评估向在校儿童提供铁补充剂对儿童血红蛋白浓度和贫血患病率的效果。
对象/方法：从巴基斯坦西北部的 30 所学校中选择 5-17 岁的儿童和青少年进行纵向铁补充剂干预。儿童接受为期 24 周的每周一次铁补充剂（200mg 硫酸亚铁，含 63mg 元素铁）（n=352）；或同样的补充剂每周两次，持续 12 周（n=298）或不服用片剂（n=298）。在基线、12 周和 24 周时，使用指尖血样估算血红蛋白浓度。在 36 周时进行随访样本采集。
与未服用铁补充剂的儿童相比，接受铁补充剂 12 周后，每周一次服用铁补充剂的儿童（血红蛋白浓度平均增加 1.4g/l，标准差 15.0g/l，与每周两次服用铁补充剂的儿童相比，血红蛋白浓度平均增加 2.5g/l，标准差 14.5g/l），血红蛋白浓度出现非显著增加。与未服用铁补充剂的儿童相比，每周一次或每周两次服用铁补充剂的儿童贫血患病率均无显著降低。在所有三组中，在随访期间（24-36 周）贫血患病率均增加。
与未服用铁补充剂的儿童相比，每周一次和每周两次铁补充剂与血红蛋白浓度的显著增加无关。在所有组中，基线血红蛋白浓度是血红蛋白增加的最强预测因素。缺乏改善可能源于中度基线贫血患病率（33%）；其他微量营养素缺乏；可变的依从性；或由于膳食铁和其他营养素的季节性变化导致血红蛋白状况恶化。
