Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions

Objective: Anemia is a major public health problem caused by multiple factors. Vitamin A (VA) depletion can affect hemoglobin concentration (Hb). This study investigated the improvement in Hb and VA status in preschool Indonesian children following supplementation with 210 mumol VA and deworming with 400 mg albendazole. Subjects and design: Indonesian children (n=131) infected with Ascaris lumbricoides and/or Trichuris trichiura were enrolled. The children were grouped by length of time since receiving 210 mumol VA through the local health system. Group 1 (VA administered greater than or equal to4 month before baseline) included 51 children with Ascaris and 29 children with Trichuris. Group 2 had received VA less than or equal to1 month of baseline from the local health post and included 51 children. Intervention and methods: Immediately following baseline Hb and VA status assessment (modified relative dose response (MRDR) test), Group 1 children were given 210 mumol VA and 400 mg albendazole. Group 2 were randomized to be dewormed either 1 week before, at the same time or 1 week after baseline MRDR and Hb measures. Follow-up assessment was 3-4 weeks after baseline. Results: VA status in Group 1 significantly improved in children with either Ascaris (P<0.0001) or Trichuris (P=0.028). Although the prevalence of anemia declined, the improvement in Hb was not significant (P=0.08). In Group 2, improvement in VA status from the VA delivered through the public health system was maintained for more than 1 month. Hb improved (P=0.0037) and this improvement appeared to be associated with the length of time between deworming and follow-up assessments. Conclusion: Public health supplementation programs to improve VA status may also increase Hb concentrations and decrease anemia prevalence, especially when linked to deworming. Sponsorship: These studies were supported by the Thrasher Research Fund, SmithKline Beecham and Hatch-Wisconsin Agricultural Experiment Station number WIS04533.