THE EFFECTIVENESS OF A SCHOOL-BASED INTERVENTION FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA

Authors

  • Eliana Pereira Vellozo, PhD Adolescent Medicine Sector, Department of Pediatrics, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, São Paulo, Brazil
  • Francisco Plácido Nogueira Arcanjo, PhD Department of Health Science, Universidade Federal do Ceará, Campus Sobral, Ceará, Brazil
  • Maria Sylvia de Souza Vitalle, PhD Adolescent Medicine Sector, Department of Pediatrics, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, São Paulo, Brazil
  • Mauro Fisberg, PhD Adolescent Medicine Sector, Department of Pediatrics, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, São Paulo, Brazil
  • Carla Cristina Enes, PhD Center of Life Science, Pontifical Catholic University of Campinas, Campinas, Brazil
  • André Luiz Monezi Andrade, PhD Center of Life Science, Pontifical Catholic University of Campinas, Campinas, Brazil
  • Sheila Rejane Niskier, MSc Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
  • Aline de Piano Ganen, PhD Department of Nutrition, São Camilo University Center, São Paulo, Brazil
  • Peter Richard Hall Faculty of Medicine, Centro Universitário INTA, Sobral, Brazil https://orcid.org/0000-0002-2865-700X
  • Josefina Aparecida Pellegrini Braga, PhD Hematology Sector, Department of Pediatrics, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
  • Maria Aparecida Zanetti Passos, PhD Postgraduate Program in Education and Health in Childhood and Adolescence, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil

DOI:

https://doi.org/10.29121/granthaalayah.v9.i5.2021.3919

Keywords:

Anemia, Iron Deficiency, Child Nutrition, Iron Supplements, Hemoglobins

Abstract [English]

Background: In Brazil, iron deficiency anemia is considered a public health problem, which has a direct impact on the process of child growth and development. To assess the impact of a powdered supplement added to food preparations, on hemoglobin (Hb) levels and other hematimetric parameters in children. Method: This study is a double-blind, community-controlled clinical trial conducted in education centers in the northeast of Brazil. In this trial, food preparations were offered with a powdered supplement, enriched with iron (intervention) and control (no supplementation), Monday through Friday, for 60 days. Two biochemical evaluations were performed to determine Hb, hematocrit (Ht), mean corpuscular volume and ferritin levels before and after the intervention. Results: For participants in the 6- to 59-month age range, we identified an increase in mean Hb concentrations and other hematimetric parameters. In the 5- to 11-year age group, there was a significant increase in both groups for Hb and Ht values, and mean Hb concentration was significantly greater in the intervention group (12.25±0.76 vs. 11.93±0.94, p<.0035). In the 12- to 14-year-olds, all variables analyzed presented an increase. Conclusions: This school-based intervention effectively increased Hb concentrations other hematimetric parameters and reduced the prevalence of anemia in children and adolescents.

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References

World Health Organization. Nutritional anaemias: tools for effective prevention and control. Geneva: World Health Organization; 2017. Available at: https://apps.who.int/iris/bitstream/handle/10665/259425/9789241513067-eng.pdf. Accessed February 14, 2021.

Kassebaum NJ; GBD 2013 Anemia Collaborators. The Global Burden of Anemia. Hematol Oncol Clin North Am. 2016;30(2):247-308. doi:10.1016/j.hoc.2015.11.002 DOI: https://doi.org/10.1016/j.hoc.2015.11.002

Sociedade Brasileira de Pediatria. Consenso sobre anemia ferropriva: mais que uma doença, uma urgência médica! Rio de Janeiro: SBP; 2018. Available at: https://www.sbp.com.br/fileadmin/user_upload/21019f-Diretrizes_Consenso_sobre_anemia_ferropriva-ok.pdf. Accessed February 14, 2021.

Ministério da Saúde (Brazil). Portal de Boas Práticas em Saúde da Mulher, da Criança e do Adolescente. Postagens - Carências Nutricionais: Anemia Ferropriva. Brasília: Ministério da Saúde; 2019. Available at: https://portaldeboaspraticas.iff.fiocruz.br/atencao-crianca/carencias-nutricionais-anemia-ferropriva/. Accessed February 14, 2021.

Morais D de C, Dutra LV, Franceschini S do C, Priore SE. Insegurança alimentar e indicadores antropométricos, dietéticos e sociais em estudos brasileiros: uma revisão sistemática [Food insecurity and anthropometric, dietary and social indicators in Brazilian studies: a systematic review]. Cien Saude Colet. 2014;19(5):1475-1488. doi:10.1590/1413-81232014195.13012013 DOI: https://doi.org/10.1590/1413-81232014195.13012013

Oliveira JS, Lira PIC, Maia SR, Sequeira LAS, Amorim RCA Batista Filho M. Insegurança alimentar e estado nutricional de crianças de Gameleira, zona da mata do Nordeste brasileiro. Rev Bras Saude Mater Infant. 2010;10(2):237-245. doi: 10.1590/S1519-38292010000200011 DOI: https://doi.org/10.1590/S1519-38292010000200011

World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011. Available at: https://www.who.int/vmnis/indicators/haemoglobin.pdf. Accessed February 14, 2021.

Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Chicago: Human Kinetics Books; 1988.

World Health Organization. Worldwide prevalence of anaemia 1993–2005 WHO Global Database on Anaemia. Geneva: World Health Organization; 2008. Available at: https://apps.who.int/iris/bitstream/handle/10665/43894/9789241596657_eng.pdf?ua=1. Accessed February 14, 2021.

Ministério da Saúde (Brazil), Centro Brasileiro de Análise e Planejamento. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher – PNDS 2006: Dimensões do processo reprodutivo e da saúde da criança. Série G. Estatística e Informação em Saúde. Brasília: Ministério da Saúde; 2009. Available at: http://bvsms.saude.gov.br/bvs/publicacoes/pnds_crianca_mulher.pdf. Accessed February 14, 2021.

Beard JL. Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr. 2001;131(2S-2):568S-580S. doi:10.1093/jn/131.2.568S DOI: https://doi.org/10.1093/jn/131.2.568S

World Health Organization. Iron deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva: World Health Organization; 2001. Available at: https://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf. Accessed February 14, 2021.

Domellöf M, Thorsdottir I, Thorstensen K. Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res. 2013;57:10.3402/fnr.v57i0.21667. doi:10.3402/fnr.v57i0.21667 DOI: https://doi.org/10.3402/fnr.v57i0.21667

United Nations. We can end poverty: Millennium development goal and beyond 2015. Available at: https://www.un.org/millenniumgoals/bkgd.shtml. Accessed February 14, 2021.

Man Y, Xu T, Adhikari B, Zhou C, Wang Y, Wang B. Iron supplementation and iron-fortified foods: a review. Crit Rev Food Sci Nutr. 2021;1-22. doi:10.1080/10408398.2021.1876623 DOI: https://doi.org/10.1080/10408398.2021.1876623

Arcanjo FPN, da Costa Rocha TC, Arcanjo CPC, Santos PR. Micronutrient Fortification at Child-Care Centers Reduces Anemia in Young Children. J Diet Suppl. 2019;16(6):689-698. doi:10.1080/19390211.2018.1474987 DOI: https://doi.org/10.1080/19390211.2018.1474987

Akkermans MD, Eussen SR, van der Horst-Graat JM, van Elburg RM, van Goudoever JB, Brus F. A micronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children: a randomized, double-blind controlled trial. Am J Clin Nutr. 2017;105(2):391-399. doi:10.3945/ajcn.116.136143 DOI: https://doi.org/10.3945/ajcn.116.136143

Duque X, Martinez H, Vilchis-Gil J, Mendoza E, Flores-Hernández S, Morán S, Navarro F, Roque-Evangelista V, Serrano A, Mera RM. Effect of supplementation with ferrous sulfate or iron bis-glycinate chelate on ferritin concentration in Mexican schoolchildren: a randomized controlled trial. Nutr J. 2014;13:71. doi:10.1186/1475-2891-13-71 DOI: https://doi.org/10.1186/1475-2891-13-71

Bansal PG, Toteja GS, Bhatia N, Vikram NK, Siddhu A. Impact of weekly iron folic acid supplementation with and without vitamin B12 on anaemic adolescent girls: a randomised clinical trial. Eur J Clin Nutr. 2016;70(6):730-737. doi:10.1038/ejcn.2015.215 DOI: https://doi.org/10.1038/ejcn.2015.215

Hettiarachchi M, Liyanage C, Wickremasinghe R, Hilmers DC, Abrams SA. The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka. Eur J Clin Nutr. 2008;62(7):856-865. doi:10.1038/sj.ejcn.1602791 DOI: https://doi.org/10.1038/sj.ejcn.1602791

Goyle A. Effect of micronutrient fortified biscuit supplementation on the weight, height and BMI of adolescent girls. Coll Antropol. 2012;36(2):573-579.

De-Regil LM, Suchdev PS, Vist GE, Walleser S, Peña-Rosas JP. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. Cochrane Database Syst Rev. 2011;(9):CD008959. doi:10.1002/14651858.CD008959.pub2 DOI: https://doi.org/10.1002/14651858.CD008959.pub2

Suchdev PS, Jefferds MED, Ota E, da Silva Lopes K, De-Regil LM. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. Cochrane Database Syst Rev. 2020;2(2):CD008959. doi:10.1002/14651858.CD008959.pub3 DOI: https://doi.org/10.1002/14651858.CD008959.pub3

World Health Organization. WHO guideline: use of multiple micronutrient powders for point-of-use fortification of foods consumed by infants and young children aged 6–23 months and children aged 2–12 years. Geneva: World Health Organization; 2016. Available at: https://www.who.int/publications/i/item/9789241549943. Accessed February 14, 2021.

Published

2021-05-31

How to Cite

Vellozo, E. P., Arcanjo, F. P. N., Vitalle, M. S. de S., Fisberg, M., Enes, C. C., Andrade, A. L. M., Niskier, S. R., Ganen, A. de P., Hall, P. R., Braga, J. A. P., & Passos, M. A. Z. . (2021). THE EFFECTIVENESS OF A SCHOOL-BASED INTERVENTION FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA. International Journal of Research -GRANTHAALAYAH, 9(5), 113–126. https://doi.org/10.29121/granthaalayah.v9.i5.2021.3919

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