Effects of weekly iron supplementation on hemoglobin and cognition in school children, Hat Yai, Thailand

Rassamee Sungthong, Epidemiology Unit, F. of Medicine, PSU

. Grant : TRF
Published : Research Report
Key words : hemoglobin, cognition, iron deficiency anemia (IDA)

Background

1. Iron deficiency anemia (IDA) is a common nutritional problem worldwide, especially in children.

2. Health concerns of IDA in children is cognitive and development impairment in infants and children.

3. Daily iron supplementation is one option to prevent & correct IDA.

4. Potential side effects of daily iron supplementation are nausea, vomiting and epigastric discomfort.

5. Equivalent efficacy between weekly and daily iron supplementation on Hb has been de-monstrated.

6. Thus weekly iron supplementation may offer an alternative supplement to lessen cost & side-effect from daily iron supplementation.

7. Fourth National Food and Nutrition Survey in 1995 : Anemia in Thai children 6-14 years old = 20.5%

8. The effect of weekly iron supplementation in school children has not been studied in Thailand.

9. The effect of weekly iron supplementation on cognitive outcome is lacking.

Rationale

Combining all these information, there is a need to get conclusion on effect of different sup-plementation on hematological and cognitive improvement in Thai children.

Objectives

1. To compare the effects between weekly and daily iron supplementation on iron status.

2. To compare the effects of weekly and daily iron supplementation on cognitive function.

Hypothesis

- After 16 weeks of iron supplementation :

(Hb2-Hb1) of weekly - (Hb2-Hb1) of daily supplement <0.5 gm/dL.

(IQ2-IQ1) of weekly - (IQ2-IQ1) of daily <5 points.

Hb1 = Hb before supplementation. IQ1 = TONI score before supplementation.

Hb2 = Hb after supplementation. IQ2 = TONI score after supplementation.

Methodology

1. Study design : randomized control trial

2. Study site : schools in rural area, Hat Yai

3. Study sample : children from P1-P6

4. Sample size : at least 31 cases for each intv.

5. This study has been approved by Ethics Committee on Human Research of the Faculty of Medicine, PSU.

Conclusion

There is no significant difference of Hb change & I.Q. change between weekly and daily iron supplementation

Recommendations

In term of public health : weekly iron supplementation can be substituted for daily iron sup-plementation to prevent and correct iron deficiency anemia in Thai school children.

Plan for data analysis

Comparing among supplementation regimens about :

1. serum ferritin level

2. body weight and height

3. 24 hr food recall

4. school performance

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