Effects of iron supplementation twice a week on attention score and haematologic measures in female high school students. Predictors of adherence to micronutrient supplementation before and during pregnancy in Vietnam Weekly dose of Iron-Folate Supplementation with Vitamin-C in the workplace can prevent anaemia in women employees Impact of Preconception Micronutrient Supplementation on Anemia and Iron Status during Pregnancy and Postpartum: A Randomized Controlled Trial in Rural Vietnam Rationale, design, methodology and sample characteristics for the Vietnam pre-conceptual micronutrient supplementation trial (PRECONCEPT): a randomized controlled study Intermittent oral iron supplementation during pregnancy. Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh. Maternal iron deficiency anemia affects postpartum emotions and cognition. Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. Weekly micronutrient supplementation to build iron stores in female Indonesian adolescents. School-administered weekly iron-folate supplements improve hemoglobin and ferritin concentrations in Malaysian adolescent girls. Efficacy of weekly compared with daily iron supplementation. Weekly may be as efficacious as daily folic acid supplementation in improving folate status and lowering serum homocysteine concentrations in Guatemalan women. Long-term weekly iron supplementation improves and sustains nonpregnant women's iron status as well or better than currently recommended short-term daily supplementation. Sustained effectiveness of weekly iron-folic acid supplementation and regular deworming over 6 years in women in rural Vietnam Combating Iron Deficiency Anemia among School Going Adolescent Girls in a Hilly State of North India: Effectiveness of Intermittent Versus Daily Administration of Iron Folic Acid Tablets Efficacy and acceptability of two iron supplementation schedules in adolescent school girls in Lima, Peru. Efficacy of daily vs. weekly supplementation of iron in schoolchildren with low iron status. “There is Iron and Iron…” Burkinabè Women’s Perceptions of Iron Supplementation: A Qualitative Study Intestinal helminth infections, anaemia and labour productivity of female tea pluckers in Bangladesh. Once Weekly Low-dose Iron Supplementation Effectively Improved Iron Status in Adolescent Girls Impact of weekly iron folic acid supplementation with and without vitamin B12 on anaemic adolescent girls: a randomised clinical trial Weekly Iron Folate Supplementation in Adolescent Girls – An Effective Nutritional Measure for the Management of Iron Deficiency Anaemia The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya The effect of weekly iron supplementation on anaemia and on iron deficiency among female tea pluckers in Bangladesh. Micronutrient supplementation may reduce symptoms of depression in Guatemalan women. Anemia prophylaxis in adolescent school girls by weekly or daily iron-folate supplementation. Failure of twice-weekly iron supplementation to increase blood haemoglobin and serum ferritin concentrations: results of a randomized controlled trial. Effectiveness of weekly vitamin A (10 000 IU) and iron (60 mg) supplementation for adolescent boys and girls through schools in rural and urban East Java, Indonesia Will iron supplementation given during menstruation improve iron status better than weekly supplementation? Effect of daily versus twice weekly long-term iron supplementation on iron absorption and status in iron-deficient women: a stable isotope study. Neither Preconceptional Weekly Multiple Micronutrient nor Iron-Folic Acid Supplements Affect Birth Size and Gestational Age Compared with a Folic Acid Supplement Alone in Rural Vietnamese Women: A Randomized Controlled Trial. Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls. Identification of an appropriate strategy to control anemia in adolescent girls of poor communities. Effect of long-term intermittent supplementation with multiple micronutrients compared with iron-and-folic acid supplementation on Hb and micronutrient status of non-anaemic adolescent schoolgirls in rural Bangladesh. Effects of once-a-week or daily folic acid supplementation on red blood cell folate concentrations in women The effects of weekly iron supplementation with folic acid, vitamin A, vitamin C on iron status of Indonesian adolescents. The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania. The effect of anthelmintic treatment on helminth infection and anaemia. [Use of daily and weekly ferrous sulfate to treat anemic childbearing-age women]. Long-term intermittent multiple micronutrient supplementation enhances hemoglobin and micronutrient status more than iron + folic acid supplementation in Bangladeshi rural adolescent girls with nutritional anemia. The effect of different anthelmintic treatment regimens combined with iron supplementation on the nutritional status of schoolchildren in KwaZulu-Natal, South Africa: a randomized controlled trial. Weekly iron as a safe alternative to daily supplementation for nonanemic pregnant women. A randomised trial in Mali of the effectiveness of weekly iron supplements given by teachers on the haemoglobin concentrations of schoolchildren. Effect of daily and intermittent iron supplementation on iron status of high school girls. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya. Weekly Iron and Folic Acid Supplementation with Counseling Reduces Anemia in Adolescent Girls: A Large-Scale Effectiveness Study in Uttar Pradesh, India Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial.
INTRODUCTION Iron deficiency , associated with a decline in cognitive function , is the most common nutritional deficiency globally . The present study aim ed to identify the impact of weekly iron supplements on the attention function of female students from a high school in North Khorasan Province , Iran . METHODS This was a blind , controlled , clinical trial study , involving 200 female students who were chosen using the stratified r and omised sampling method . First , laboratory studies were performed to detect iron consumption limitations . Next , the 200 students were divided r and omly and equally into case and control groups . The case group was treated with 50 mg of ferrous sulfate twice a week for 16 weeks . We compared both groups ' data on attention , iron status and erythrocyte indices . Question naires were used to collect demographic data , while clinical data was collected using complete blood count and Toulouse-Piéron tests . Data was analysed using descriptive statistics , as well as paired and independent t-tests . RESULTS The mean attention scores of the case and control groups were 104.8 ± 7.0 and 52.7 ± 9.6 , respectively ( p < 0.001 ) . The mean haemoglobin levels of the two groups were 12.5 ± 0.9 and 11.2 ± 1.0 , respectively ( p < 0.001 ) . Compared to the control group , the attention scores and haemoglobin concentrations of the case group were found to be improved by approximately 90 % and 10 % , respectively . CONCLUSION Oral iron supplements ( 50 mg twice a week for 16 weeks ) were able to improve the attention span and haematologic indices of female high school students Background Poor adherence to micronutrient supplementation often limits the effectiveness of public health programs . While predictors of adherence to micronutrient supplementation during pregnancy are well documented , information on adherence to preconception supplements is scarce . The objective of this study was to describe the predictors of adherence to preconception and prenatal micronutrient supplementation among women participating in a r and omized control trial in Vietnam . Methods Adherence data were collected prospect ively from a double blind r and omized controlled trial in rural Vietnam . Five thous and eleven women of reproductive age were r and omized to receive preconception supplements for weekly consumption containing either : Folic Acid , Iron and Folic Acid ( IFA ) , or Multiple Micronutrients .  Women who became pregnant received prenatal IFA supplements for daily consumption through delivery . Village health workers visited participants ’ homes every two weeks to deliver supplements and record consumption and side effects . Multivariate logistic regression was used to assess individual , household , and programmatic predictors of supplement adherence . Results Adherence was high with 78 and 82 % of the women consuming more than 80 % of the preconception and prenatal supplements , respectively . Women of minority ethnicity ( OR = 0.78 95 % CI = 0.67 , 0.91 ) and farmers ( OR = 0.71 95 % CI = 0.58 , 0.88 ) were less likely to consume > 80 % of the preconception supplements while socioeconomic status ( SES ) ( OR = 2.71 highest vs. lowest quintile ; 95 % CI = 2.10 , 3.52 ) was positively associated with > 80 % adherence in the entire preconception sample with available information ( n = 4417 ) . Women in their first pregnancy had lower prenatal adherence compared to multiparous women . At the programmatic level , each village health worker visit was associated with higher odds of > 80 % adherence by 3–5 % before pregnancy and 18 % during pregnancy . Conclusions Key determinants of adherence included SES , ethnicity , occupation ( farmer ) and parity which may be helpful for targeting women for counseling on supplement adherence . Increased contact with village health workers was positively associated with  adherence  to micronutrient supplementation both before conception and during pregnancy indicating the need for re sources to support community outreach to women of reproductive age . Trial registration NCT01665378 . Registered on August 12 , 2012 Objective : To assess if a weekly dose of iron and folic acid along with vitamin C , in the workplace would reduce the prevalence of anaemia . Methodology : A multi-pronged intervention was carried out to reduce the prevalence of anaemia among workers of 7 apparel manufacturing factories using a regime consisting of a supervised single dose of albendazole ( 400 mg ) followed by a weekly dose of dried ferrous sulphate ( 150 mg ) , folic acid ( 0.5 mg ) and vitamin C ( 100 mg ) . Workers were provided information on the causes of anaemia and its prevention . The total duration of the intervention was 16 weeks . Haemoglobin levels of a r and omly selected sample of workers were tested before and after the intervention using a computerized non-cyan-meth-haemoglobin method . Results : Of the 10810 workers who were enrolled a sample of 515 workers was r and omly selected for the blood investigations . At the end of the intervention ( 18 weeks after the first blood sample was collected ) only 361 out of the 515 who had been enrolled a little more than 16 weeks earlier still remained in the factories and among women 279 out of 385 enrolled were still working in the factories . In the 385 unmatched sample s the number of anaemic women had reduced from 141 before the intervention to 79 after - mean haemoglobin increasing from 12.2 to 13.0 ( p < 0.001 ) and in the 279 paired sample s prevalence of anaemia had reduced from 105 to 58 - mean haemoglobin increasing from 12.1 to 13.0 ( p < 0.001 ) . Conclusions : Our results demonstrated that in re source poor regions , where prevalence of anaemia is high , the workplace may be considered an ideal location to give a weekly supervised dose of iron , folic acid and vitamin C to effectively tackle the problem and probably improve worker efficiency Objective Preconception micronutrient interventions may be a promising approach to reduce anemia and iron deficiency during pregnancy , but currently we have limited data to inform policies . We evaluated whether providing additional pre-pregnancy weekly iron-folic acid ( IFA ) or multiple micronutrient ( MM ) supplements compared to only folic acid ( FA ) improves iron status and anemia during pregnancy and early postpartum . Methods We conducted a double blind r and omized controlled trial in which 5011 Vietnamese women were provided with weekly supplements containing either only 2800 μg FA ( control group ) , IFA ( 60 mg Fe and 2800 μg FA ) or MM ( 15 micronutrients with similar amounts of IFA ) . All women who became pregnant ( n = 1813 ) in each of the 3 groups received daily IFA ( 60 mg Fe and 400 μg FA ) through delivery . Hematological indicators were assessed at baseline ( pre-pregnancy ) , during pregnancy , 3 months post-partum , and in cord blood . Adjusted generalized linear models were applied to examine the impact of preconception supplementation on anemia and iron stores , using both intention to treat and per protocol analyses ( women consumed supplements ≥ 26 weeks before conception ) . Results At baseline , 20 % of women were anemic , but only 14 % had low iron stores ( ferritin < 30 μg/L ) and 3 % had iron deficiency ( ferritin < 12 μg/L ) . The groups were balanced for baseline characteristics . Anemia prevalence increased during pregnancy and post-partum but was similar among intervention groups . In intention to treat analyses , prenatal ferritin was significantly higher among women receiving MM ( geometric mean ( μg/L ) [ 95 % CI ] : 93.6 [ 89.3–98.2 ] ) and IFA ( 91.9 [ 87.6–96.3 ] ) compared to control ( 85.3 [ 81.5–89.2 ] ) . In per protocol analyses , women receiving MM or IFA  had higher ferritin 3 months postpartum ( MM 118.2 [ 109.3–127.8 ] ) , IFA 117.8 [ 108.7–127.7 ] vs control 101.5 [ 94.0–109.7 ] ) and gave birth to infants with greater iron stores ( MM 184.3 [ 176.1–192.9 ] ) , IFA 189.9 [ 181.6–198.3 ] vs control 175.1 [ 167.9–182.6 ] ) . Conclusion Preconception supplementation with MM or IFA result ed in modest increases in maternal and infant iron stores but did not impact anemia . Further research is needed to characterize the etiology of anemia in this population and identify effective interventions for reducing prenatal anemia . Trial Registration Clinical Trials . Gov Background Low birth weight and maternal anemia remain intractable problems in many developing countries . The adequacy of the current strategy of providing iron-folic acid ( IFA ) supplements only during pregnancy has been question ed given many women enter pregnancy with poor iron stores , the substantial micronutrient dem and by maternal and fetal tissues , and programmatic issues related to timing and coverage of prenatal care . Weekly IFA supplementation for women of reproductive age ( WRA ) improves iron status and reduces the burden of anemia in the short term , but few studies have evaluated subsequent pregnancy and birth outcomes .The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient ( MM ) supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only . This paper provides an overview of study design , methodology and sample characteristics from baseline survey data and key lessons learned . Methods / design We have recruited 5011 WRA in a double-blind stratified r and omized controlled trial in rural Vietnam and r and omly assigned them to receive weekly supplements containing either : 1 ) 2800 μg folic acid 2 ) 60 mg iron and 2800 μg folic acid or 3 ) MM . Women who become pregnant receive daily IFA , and are being followed through pregnancy , delivery , and up to three months post-partum . Study outcomes include birth outcomes and maternal and infant iron status . Data are being collected on household characteristics , maternal diet and mental health , anthropometry , infant feeding practice s , morbidity and compliance . Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA . Findings will generate new information to help guide policy and programs design ed to reduce the burden of anemia in women and children and improve maternal and child health outcomes in re source poor setting s . Trial registration RATIONALE It has been suggested that in pregnant women weekly iron supplements are as effective as daily supplements in preventing iron deficiency anaemia ( IDA ) . OBJECTIVE To compare the effectiveness of prophylactic antenatal oral iron supplements given weekly , thrice weekly and daily in preventing IDA in pregnancy . DESIGN A r and omised control trial . SETTING University antenatal clinic , ( UANC ) Galle . SUBJECTS AND METHOD An oral iron supplement containing 100 mg of elemental iron was r and omly given weekly ( n = 26 ) thrice weekly ( n = 35 ) and daily ( n = 31 ) to 92 women who were 14 to 24 weeks pregnant .  Haemoglobin ( Hb ) , serum ferritin ( SF ) and haematocrit ( Hct ) were assessed before and after 12 to 20 weeks of supplementation and a logistic regression analysis carried out . RESULTS The risk of developing anaemia was significantly higher in the weekly ( odds ratio 15 , 95 % CI 1.4 - 165.6 , p < 0.03 ) and possibly higher in the thrice weekly ( odds ratio 3 , 95 % CI 0.3 - 30.3 , p = 0.3 ) groups . The risk of developing iron deficiency ( SF < 12 micrograms/l ) was also significantly higher in the weekly ( odds ratio 18 , 95 % CI 2.8 - 115.5 , p < 0.003 ) and thrice weekly ( odds ratio 10 , 95 % CI 1.6 - 64.8 , p < 0.02 ) groups . CONCLUSION Prophylactic oral iron supplements when given intermittently were not effective in preventing iron deficiency anaemia in pregnancy BACKGROUND Although iron deficiency is a major cause of anemia , other micronutrient deficiencies may also play a role . OBJECTIVE We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh . DESIGN Anemic ( hemoglobin < 12.0 g/dL ) girls ( n = 197 ) aged 14 - 18 y from rural schools in Dhaka District were entered into a r and omized double-blind trial and received twice-weekly supplements of iron and folic acid ( IFA group ) or multiple micronutrients ( 15 micronutrients , including iron and folic acid ; MMN group ) for 12 wk . RESULTS At recruitment , the characteristics of the girls in the 2 groups were not significantly different , except for family size and body mass index . At the end of the study , although both groups benefited significantly from supplementation , mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups . Compared with the IFA group , girls in the MMN group had significantly greater increases in mean serum vitamin A , plasma vitamin C , red blood cell folic acid , and riboflavin concentrations ( assessed as erythrocyte glutathione reductase activation coefficient ) . After 12 wk of supplementation , only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group . CONCLUSIONS Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls . More frequent doses may be needed to achieve full benefit The aim of this study was to determine whether iron deficiency anemia ( IDA ) in mothers alters their maternal cognitive and behavioral performance , the mother-infant interaction , and the infant 's development . This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers . This prospect i ve , r and omized , controlled , intervention trial was conducted in South Africa among 3 groups of mothers : nonanemic controls and anemic mothers receiving either placebo ( 10 microg folate and 25 mg vitamin C ) or daily iron ( 125 mg FeS0(4 ) , 10 microg folate , 25 mg vitamin C ) . Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum ( n = 81 ) . Maternal hematologic and iron status , socioeconomic , cognitive , and emotional status , mother-infant interaction , and the development of the infants were assessed at 10 wk and 9 mo postpartum . Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers . However , iron treatment result ed in a 25 % improvement ( P < 0.05 ) in previously iron-deficient mothers ' depression and stress scales as well as in the Raven 's Progressive Matrices test . Anemic mothers administered placebo did not improve in behavioral measures . Multivariate analysis showed a strong association between iron status variables ( hemoglobin , mean corpuscular volume , and transferrin saturation ) and cognitive variables ( Digit Symbol ) as well as behavioral variables ( anxiety , stress , depression ) . This study demonstrates that there is a strong relation between iron status and depression , stress , and cognitive functioning in poor African mothers during the postpartum period . There are likely ramifications of this poorer " functioning " on mother-child interactions and infant development , but the constraints around this relation will have to be defined in larger studies BACKGROUND Iron deficiency is the most common micronutrient deficiency and affects > 2 billion persons worldwide , leading to anemia in > 40 % of women of reproductive age in the developing world . OBJECTIVE The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant . DESIGN Participants with a hemoglobin concentration of 80 - 120 g/L were entered into a r and omized , double-blind , placebo-controlled trial and received supplements of placebo , vitamin A , iron + folic acid , or iron + folic acid + vitamin A weekly for 12 wk . The supplements contained 2.42 mg vitamin A ( retinol ) as retinyl palmitate , 120 mg elemental Fe as ferrous sulfate , and 3.5 mg folic acid . RESULTS Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone . There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid , but the additional effect disappeared after adjustment for baseline hemoglobin , serum vitamin A , and ferritin and the number of supplements taken . Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin . Compared with the placebo , iron + folic acid + vitamin A reduced anemia by 92 % , iron deficiency by 90 % , and vitamin A deficiency by 76 % . CONCLUSION There may be significant health benefits from a program that enhances the nutritional status of iron , folate , and vitamin A in poor urban young women before they become pregnant Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated . Subjects were 273 high-school girls allocated r and omly to four treatment groups . During a 3-mo period one group received 60 mg Fe , 750 micrograms retinol , 250 micrograms folic acid , and 60 mg vitamin C per day ; a second group received 60 mg Fe , 6000 micrograms retinol , 500 mg folic acid , and 60 mg vitamin C once a week ; a third group received 120 mg Fe and the same amount of the other three micronutrients as the second group once a week ; and a fourth group received only placebos . All subjects were dewormed and supplement allocation was double blind . Blood sample s were collected at baseline , after 2 and 3 mo of supplementation , and 6 mo after the last supplement . After 2 mo of supplementation , groups supplemented weekly and daily showed similar significant improvements ( P < 0.001 ) in hemoglobin and retinol concentrations , and supplementation for 3 instead of 2 mo did not significantly increase these two indicators . After 3 mo , the increase in ferritin was approximately equal to 27 micrograms/L in the daily and 14 - 15 micrograms/L in the weekly groups ( P < 0.001 ) , the latter having a final concentration of 42 - 45 micrograms/L. At 6 mo postsupplementation there were no significant differences among daily and weekly groups , but the ferritin concentration was still approximately equal to 10 - 12-micrograms/L higher ( P < 0.001 ) than in the placebo group . The group supplemented weekly with 60 mg Fe complained less about side effects than the other supplemented groups ( P < 0.05 ) . Weekly supplementation with 60 mg Fe and 6000 micrograms retinol for 3 mo was optimal for improving the iron status of the adolescents for approximately equal to 9 mo BACKGROUND Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world . OBJECTIVE We investigated whether long-term , weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls , including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia . DESIGN Subjects were 266 girls with hemoglobin concentrations of 80 - 119.9 g/L ( group A ) and 358 girls with hemoglobin concentrations of 120 - 130 g/L ( group B ) who were otherwise healthy . Two hundred sixty-six girls in group A and 268 girls in group B were r and omly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk . Ninety of the girls in group B were r and omly assigned to receive only 5 mg folic acid weekly . Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation . RESULTS By the end of the study , 2 % of the girls had dropped out and > 96 % had taken > or = 20 of the 22 tablets ; side effects were minimal . Mean plasma ferritin increased significantly in all iron-supplemented groups , independently of initial hemoglobin values and iron doses . Ferritin concentrations decreased in the girls supplemented with folic acid only . As expected , hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin . Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low . Mean hemoglobin increased significantly and consistently in relation to the length of treatment . CONCLUSION Long-term , weekly iron-folate supplementation was found to be a practical , safe , effective , and inexpensive method for improving iron nutrition in adolescent schoolgirls A reduction in the frequency of iron supplement administration to once or twice weekly is being widely examined in developing countries on the assumption that the side effects of oral iron will decrease and that the reduction in administered iron will be offset by a lesser inhibition in absorption from iron taken on the previous day . We examined this premise by measuring iron absorption from 50 mg radiolabeled ferrous sulfate in 23 female volunteer subjects divided into two groups . In the first group , a labeled ferrous sulfate supplement was given with water , and in the second group it was given with a rice-based meal . In both groups , absorption was measured in a r and omized fashion twice in each subject , once with daily and once with weekly supplementation . Those tested for daily supplementation were given an iron supplement daily for 6 d before testing whereas those tested for weekly supplementation were given no iron for 6 d before testing . When the labeled iron supplement was given with water only , absorption averaged 8.5 % with daily and 9.8 % with weekly administration compared with 2.3 % and 2.6 % , respectively , when given with food . The 13 % lower absorption observed with daily administration in both groups was not statistically significant ( P > 0.20 ) . These results indicate that there is no significant absorptive advantage in giving iron less often than once daily Daily folic acid ( FA ) supplementation improves folate status , lowers circulating homocysteine ( Hcy ) concentrations , and reduces the risk of neural tube defects . Little is known about the efficacy of weekly FA supplementation . The objective of this study was to compare the efficacy of weekly and daily FA supplementations in improving folate and vitamin B-12 status and lowering Hcy concentrations in healthy reproductive-aged women . A r and omized , double-blind supplementation trial was conducted in Guatemala . A total of 459 women were assigned r and omly to 4 groups to receive weekly ( 5000 or 2800 microg ) or daily ( 400 or 200 microg ) FA for 12 wk . Daily and weekly iron , zinc , and vitamin B-12 were also provided . We determined serum and RBC folate by microbiological assays , but the latter was available only at baseline . Serum Hcy and vitamin B-12 were also measured . We used generalized linear regression models to assess the effects of treatment on biochemical indicators . Supplementation improved folate status similarly across all 4 groups . Overall , mean serum folate concentrations increased by 15.4 nmol/L ( 95 % CI : 13.8 , 16.9 ) and the geometric mean serum Hcy concentration decreased by 9.8 % ( 95 % CI : -12.3 , -7.1 ) . Daily supplementation improved serum vitamin B-12 by 20 % ( 95 % CI : 8 , 33.2 ) , whereas weekly supplementation had no effect . In conclusion , weekly FA ( either high or low dose ) plus vitamin B-12 may be as efficacious as daily supplementation in improving serum folate and lowering Hcy concentrations in healthy women of reproductive age This 7-mo double-blind study compared the efficacy of two iron supplementation schemes in improving iron nutrition among 116 healthy fertile-age women . They were r and omly distributed in three groups , receiving : Group 1 , iron + folate ( 60 mg and 250 microg , respectively ) daily for 3 mo ( currently recommended scheme ) , and folate ( 250 microg ) weekly the subsequent 4 mo . Group 2 , folate daily , and 60 mg iron only once weekly for 3 mo , and then weekly iron + folate for 4 mo . Group 3 , folate daily for 3 mo and then weekly for 4 mo . At baseline , 16 % had depleted stores ( plasma ferritin < 15 microg/L ) and 16 % had hemoglobin levels < 125 g/L. Eight percent had hemoglobin levels < 120 g/L. In Group 1 hemoglobin and ferritin increased at 3 mo but returned to near basal conditions after 4 mo of weekly folate . In Group 2 , hemoglobin and ferritin increased progressively throughout the 7 mo but mostly after 3 mo . Group 3 did not change . Side effects were highest with daily iron . Weekly iron supplementation over 7 mo ( 30 doses ) improved and sustained iron nutrition at least as effectively and was better tolerated than 90 daily iron supplements consumed during 3 mo Background Weekly iron-folic acid ( IFA ) supplementation and regular deworming is effective for the prevention of iron deficiency and anaemia in women of child-bearing age . Between 2006 and 2013 , a program of weekly IFA and biannual deworming was implemented in Yen Bai province , Vietnam . In this study we aim ed to determine the effectiveness of the program in reducing anaemia and the prevalence of hookworm infection after 72 months ( six years ) . Methods This prospect i ve cohort study followed up a cohort of 389 women of child-bearing age from baseline until six years after the introduction of the weekly IFA ( one tablet containing 200 mg ferrous sulphate , 0.4 mg folic acid ) and deworming ( one 400 mg tablet of albendazole given twice yearly ) program ( May 2006 to 2012 ) . In each of the six surveys ( baseline and five follow-up surveys ) we measured haemoglobin and ferritin , and the burden of soil transmitted helminth ( STH ) infections , and in the 72 month survey we also administered a question naire to assess adherence and possible impediments to participating in the program . Results Two hundred and fifty six ( 65.8 % ) of the original 389 women enrolled in the cohort attended the final 72 month survey . Haemoglobin levels were 122 g/L [ 95 % C.I. 120 , 124 ] at baseline and increased to 135g/L [ 95 % C.I. 133 , 138 ] after 72 months . The prevalence of anaemia was 37.8 % [ 95 % C.I. 31.0 , 44.7 ] at baseline and reduced to 14.3 % [ 95 % C.I. 9.5 , 19.1 ] . Hookworm infection prevalence , 75.9 % [ 95 % C.I. 68.1 , 83.8 ] at baseline , reduced to 10.2 % [ 95 % C.I. 5.4 , 15.0 ] with no moderate or heavy intensity infections . Seventy-two percent of participants reported still taking at least 75 % of the weekly supplements , and 85.0 % had taken the most recent deworming treatment . Discussion Anaemia rates fell significantly during the six-year program , and STH infections were eliminated as a public health risk . Adherence was well maintained but long-term sustainability is challenging in the absence of ongoing external support Background : National surveys in India have documented an increasing number of adolescent girls suffering from anemia . Efforts to build iron stores in adolescent girls will help them improve their prepregnancy hemoglobin level . To assess the effectiveness of school-based supervised weekly , bi – weekly , and daily regimen of iron folic tablets in the treatment of anemia among adolescent girls . Methods : This r and omized clinical trial included 331 anemic school going adolescent girls of Shimla district of North India . Study subjects were r and omized to once weekly , bi – weekly , and daily iron folic acid regimen group . An intent-to-treat approach was used to analyze the change in hemoglobin level and serum ferritin levels at the end of the trial period . Results : The rate of change of hemoglobin and serum ferritin levels from baseline to the end of the intervention was found to be similar in all the three groups ( P = 0.64 and 0.98 for change in hemoglobin and serum ferritin ) . Bi-weekly treatment regimen results in comparatively more increase in hemoglobin levels ( 3.1 g/dl ) as compared to once weekly ( 2.4 g/dl ) and daily groups ( 2.3 g/dl ) ( ANOVA F statistics = 6.08 , P = 0.003 ) . Among the study subjects who reported side effects , more were from daily regimen group ( 55 % ) as compared to intermittent regimen group ( 25 % in bi-weekly group ; 18 % in weekly group ; P < 0.001 ) . Conclusions : In Shimla hills of North India , school-based intermittent iron-folic acid therapy is a feasible and effective intervention for increasing hemoglobin and serum ferritin levels of anemic adolescent girls To assess the efficacy and acceptability of a daily and intermittent iron supplementation , a double-blind , placebo-controlled trial was conducted in a public school located in periurban Lima , Peru . Adolescent girls ( n = 312 ) , 12 - 18 y old , were r and omly assigned to one of the following three groups : 1 ) 60 mg iron as ferrous sulfate daily from Monday to Friday ; 2 ) 60 mg iron as ferrous sulfate 2 d/wk and 3 d placebo ( intermittent ) ; 3 ) placebo , from Monday to Friday . Field workers gave the girls supplements during school hours for 17 wk ; 296 girls completed the trial . Girls took 94 % of the expected dose of 85 pills . Few side effects were reported . Postintervention , hemoglobin ( Hb ) , serum ferritin ( SF ) and free erythrocyte protoporphyrin ( FEP ) were improved significantly in the iron-supplemented groups compared with placebo ( P<0.05 ) . Daily supplements led to higher Hb increases than intermittent supplements ( P<0.05 ) , but SF and FEP were similar between the two groups . Thus , both iron supplementation schedules were efficacious in preventing iron deficiency in adolescent girls through the school system , and the daily schedule was better than the intermittent schedule at increasing Hb values and reducing anemia Iron deficiency anemia ( IDA ) is still a major nutritional and public health problem in developing countries . The prevalence among young children and pregnant women is particularly high . Daily oral supplementation with medicinal iron is considered an effective strategy for reducing the incidence of IDA but non-compliance is a major problem with this strategy . We undertook this study to compare the results of once-weekly vs. daily oral iron supplementation in schoolchildren . Sixty children ranging between 5 and 10 years with iron deficiency anemia were selected from a school in Karachi , Pakistan and were divided into two equal groups , i.e. , daily and weekly supplementation groups . Hemoglobin ( Hb ) , hematocrit ( Hct ) , serum iron , total iron binding capacity ( TIBC ) , and serum ferritin were determined before the start of the study . Ferrous sulfate ( 200 mg ) was given daily to the daily supplementation group and once-weekly to the weekly supplementation group for 2 months . When post-supplementation values of the above-mentioned parameters were determined , a significant improvement was observed in all parameters in both groups . It is concluded that once-weekly iron supplementation is as effective as daily supplementation for the treatment of iron deficiency anemia . Moreover , weekly iron supplementation is cost effective and has no or fewer side-effects Abstract Most pregnant women in Burkina Faso are iron deficient and many are anemic . This study assessed women ’s underst and ing of anemia and the role of iron in preventing and treating this condition . A qualitative study was conducted within a r and omized controlled trial of weekly iron supplementation in a rural malaria endemic area . Focus groups with women of similar age , parity , and marital status took place in 12 of 24 study villages . Two additional focus groups were conducted with female field workers . Tape-recorded transcripts were translated into French and analyzed using Framework analysis . Anemia , for which no Mooré term or traditional treatment for anemia was evident , was described in terms of blood volume . Moderate blood loss ( diminished blood ) could be easily replaced by eating well and was not considered serious . Massive blood loss ( finished blood ) was a rare , life-threatening illness . Iron tablets could increase blood volume and help women withst and massive blood loss at delivery , but for the latter , transfusion was indicated . Women had no knowledge of iron ’s role and did not readily concede that iron supplements contained elemental iron . Neither adolescents nor field workers were convinced of the benefits of supplementing non-pregnant adolescents , who were incorrectly considered to be at low risk of anemia . Young women ’s knowledge of anemia did not provide an adequate explanatory framework to motivate anemia prevention . Improving information on the role of iron is especially important for adolescent girls who may be incorrectly considered at low risk of anemia as they have not yet experienced pregnancy We conducted a r and omized clinical intervention trial over 24 weeks on a tea estate in north-east Bangladesh to investigate the effect of iron supplementation and anthelmintic treatment on the labour productivity of adult female tea pluckers . A total of 553 full-time tea pluckers , not pregnant and not breastfeeding , were r and omly assigned to one of the four intervention groups : group 1 received iron supplementation on a weekly basis , group 2 received anthelmintic treatment at the beginning and half-way through the trial ( week 12 ) , group 3 received both iron supplementation as group 1 and anthelmintic treatment as group 2 , and group 4 was a control group and received placebos . No significant difference in labour productivity was found between the four intervention groups over the trial period . However , there was a negative association for all three worms ( Ascaris lumbricoides , Trichuris trichiura and hookworms ) between the intensity of helminth infections ( eggs/g faeces ) and all measures of labour productivity . Lower haemoglobin values and anaemia ( < 120 g/l Hb ) were both associated with lower labour productivity and more days sick and absent . Taller women with greater arm circumference were able to pluck more green leaves , earn higher wages and were absent less often Iron supplementation has been suggested as a strategy for prevention and treatment of iron deficiency ( ID ) and iron deficiency anemia ( IDA ) in many countries , but non-compliance of daily regimens and common dosage remain as major challenges . The aim of this study was to investigate the effects of low dose once weekly iron supplementation in adolescent girls . The study was design ed as a community-based , r and omized , supplementation trial . The initial sample consisted of 200 female high school students , aged 14–16 years old , of whom 193 students concluded the study . They were r and omly selected and assigned into either iron-supplemented group ( ISG ) or iron-unsupplemented group ( IUG ) . The ISG received 150 mg ferrous sulfate once weekly for 16 weeks , whereas the IUG received nothing .  Weight , height , and hematological parameters were measured and compared between the two groups before and after the intervention . There was no significant difference between the initial measures of the two groups before the intervention . After 16 weeks of intervention , mean of hemoglobin and serum ferritin improved significantly in ISG compared to IUG . At the beginning of the study , percent of anemia , IDA , and ID in ISG were 12.5 % , 8.3 % , and 30.2 % , whereas these figures for IUG in this period of study were 14.4 , 10.3 , and 38.2 , respectively , which were not significantly different between the two groups . However , percentages of the above items at the end of study in ISG were 2.1 % , 0 % , and 21.9 % , respectively . In contrast to IUG , all cases of IDA were abolished in the ISG . Our study showed that once weekly supplementation of 150 mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescents and effectively treated IDA . There is no need for higher dosage of iron for supplementation that may cause adverse effects and bear higher costs Background / Objectives : In India , approx . 70 % of the adolescent girls are anaemic ( haemolgobin < 120 g/l ) . The present study was a supervised r and omised double-blind clinical trial conducted among adolescent girls ( 11–18 years ) to assess and compare the impact of weekly iron folic acid ( IFA ) supplementation with or without vitamin B12 on reduction in the prevalence of anaemia and on blood/serum levels of haemoglobin , serum ferritin , folic acid and vitamin B12.Subjects/ Methods : Community-based r and omized controlled trial was carried out in Kirti Nagar slums of West Delhi . A total of 446 mild ( 100–119 g/l ) and moderate ( 70–99 g/l ) anaemic volunteer adolescent girls were identified and r and omised into two groups . Weekly supervised supplementation was given for 26 weeks : Group A ( n=222 ) : iron ( 100 mg ) , folic acid ( 500 mcg ) and placebo ; Group B ( n=224 ) : iron ( 100 mg ) , folic acid ( 500 mcg ) and cyanocobalamin ( 500 mcg for 6 weeks and 15 mcg for 20 weeks ) . Haemoglobin , serum ferritin , folic acid and vitamin B12 levels were assessed at baseline and after intervention . A total of 373 subjects completed 26 weeks of supplementation successfully . Results : The mean haemoglobin increased from 106.7±11.2 g/l and 108.9±8.91 g/l in Group A and Group B at baseline to 116.4±10.8 g/l ( P<0.001 ) and 116.5±10.26 g/l ( P<0.001 ) at post-intervention , respectively , with the reduction in the prevalence of anaemia by 35.9 % in Group A and 39.7 % in Group B ( P>0.05 ) . A total of 63.3 % participants had deficient vitamin B12 levels ( < 203 pg/ml ) at baseline , which reduced to 40.4 % after intervention with cyanocobalamin , whereas no change was observed in vitamin B12 status in the other group . Significant reduction ( P=0.01 ) in the prevalence of serum ferritin deficiency ( < 15 ng/ml ) was observed in the group supplemented with vitamin B12 ( from 36.5 to 6.4 % ) as compared with the other group supplemented with only IFA ( from 39.1 to 15.2 % ) . Conclusions : IFA supplementation with or without vitamin B12 is an effective measure to cure anaemia . Although addition of vitamin B12 had similar impact on improving haemoglobin status as IFA alone , it result ed in better ferritin status . Hence , more multi-centre studies with a longer duration of supplementation or higher dose of vitamin B12 may be undertaken to assess the possible impact of vitamin B12 on improving haemoglobin levels in the population Introduction : Nutritional anaemia in India is common morbidity seen in late adolescent and young female population . There are many conflicting opinions regarding dosage of iron folic acid supplementation for managing this simple nutritional deficiency disorder . Hence , this ‘ R and omized Controlled Trial ’ was undertaken in adolescent girls suffering from Iron Deficiency Anaemia visiting ‘ Urban Health and Training Centre ’ situated in urban slum area . The aim of this study was to assess the ( a ) Impact of weekly iron folic acid supplementation in comparison with daily iron supplementation for the management of Iron Deficiency Anaemia in adolescent girls visiting ‘ Urban Health and Training Centre ’ ; ( b ) Adverse drug reaction profile in ‘ Weekly Iron Folic Acid Supplementation ’ and ‘ Daily Iron Folic Acid Supplementation ’ regimes ; ( c ) Compliance profile for ‘ Weekly Iron Folic Acid Supplementation ’ and ‘ Daily Iron Folic Acid Supplementation ’ regimes in adolescent girls . Methods and Material : R and omized controlled trial was conducted in adolescent girls visiting ‘ Urban Health and Training Centre ’ during the study period June , 2011 to October , 2012 . The 120 anaemic ( Haemoglobin < 12 gm% ) adolescent girls ( 10 - 19 years ) were distributed r and omly by block r and omization in two groups ; one receiving daily Iron and Folic Acid supplementation and in other group receiving weekly Iron and Folic Acid supplementation for 3 months . All the study subjects were given de-worming ( Albendazole 400 mg ) and required health education separately . Both the groups were monitored for Haemoglobin estimation , compliance and adverse drug reactions , if any . Open-Epi Statistical Software was used for data analysis . Results : The mean age of study subjects in ‘ Daily Iron and Folic Acid Supplementation ’  and  ‘ Weekly Iron and Folic Acid Supplementation ’ group was 13.48 and 13.55 years respectively . Their mean pre intervention Haemoglobin was 10.1±1.1 gm/dl and 10.4±1.1 gm/dl respectively . The mean rise in Haemoglobin after lean period of 1 month in respective groups was almost equal i.e. 1.0±0.7 gm/dl and 1.0±0.8 gm/dl . Adverse Drug Reactions were 8.3 % in weekly regime as compared to 13.35 % in daily regime , abdominal pain being the commonest adverse drug reaction seen . The compliance calculated as mean of unconsumed ‘ Iron and Folic Acid ’ tablets was 6.1±10.98 in ‘ Daily Iron Folic Acid Supplementation ’ group , while it was 1.3±3.15 in ‘ Weekly Iron Folic Acid Supplementation ’ group ( p=0.0012 ) , making weekly regime more promising than daily regime with better treatment compliance . Conclusions : Weekly supplementation of ‘ Iron and Folic Acid ’ in ‘ Iron Deficiency Anaemia ’ patients is as good as daily supplementation with added benefits of less adverse reactions and better compliance Background / Objectives : Iron deficiency anemia is a major public health problem in developing countries and may affect school performance and physical work capacity in nonpregnant adolescents , and may increase the risk of anemia during subsequent teenage pregnancies . We assessed the effect of weekly iron ( 120 mg elemental iron ) and vitamin A ( 25 000 IU ) supplementation on hemoglobin , iron status and malaria and nonmalaria morbidity in adolescent schoolgirls . Subjects/ Methods : A total of 279 schoolgirls aged 12–18 years from public primary schools in Kisumu , western Kenya . Double-blind r and omized placebo-controlled trial using a factorial design . Results : Five months of iron supplementation was associated with a 0.52 g dl−1 ( 0.21 , 0.82 ) greater increase in hemoglobin relative to iron placebo . The effect was only observed in girls with iron deficiency on enrollment ( 1.34 g dl−1 ( 0.79 , 1.88 ) ) , but not in iron-replete girls ( −0.20 g dl−1 ( −0.59 , 0.18 ) ) . Similar differences in treatment effect were seen between menstruating and nonmenstruating girls . The effect of iron was independent of vitamin A. The baseline prevalence of vitamin A deficiency was low ( 6.7 % ) and no sustained increase in hemoglobin was seen with weekly vitamin A ( −0.07 g dl−1 ( −0.38 , 0.25 ) ) . Incidence of malaria parasitemia was higher in the iron than iron-placebo groups ( Rate ratio 1.33 ( 0.94 , 1.88 ) ) . Conclusions : Weekly iron supplementation results in substantial increases in hemoglobin concentration in adolescent schoolgirls in western Kenya , which may outweigh possible risks caused by malaria , but only in iron-deficient or menstruating girls and not in iron-replete and nonmenstruating girls AIM To investigate the effect of weekly iron supplementation on anaemia and iron deficiency among adult , female tea pluckers . METHOD A r and omized double-blind intervention trial was conducted in a tea estate in Bangladesh where a total of 280 women received either weekly iron supplementation ( 200 mg ferrous fumarate and 200 mg folic acid )  for 24 weeks or a  matching placebo . Capillary blood sample s were drawn at baseline and post-trial to determine haemoglobin , haematocrit and ferritin concentration . Mean corpuscular haemoglobin concentration ( MCHC ) was calculated using the haemoglobin and haematocrit values . RESULTS The mean haemoglobin concentration in the supplemented group increased by 5.52 g L-1 over the study period , on average , while ferritin values decreased by 0.33 microgram L-1 . The control group showed a decrease in both mean haemoglobin ( -0.24 g L-1 ) and ferritin ( -5.32 micrograms L-1 ) . Those individuals in the supplemented group with the lowest pretrial haemoglobin and ferritin values experienced the greatest improvements post-trial , whereas nonanaemic individuals showed a decrease in both haemoglobin and ferritin concentrations . A total of 62.2 % of women in the supplemented group reported feeling better and more energetic compared to 51.1 % in the placebo group ; 14.4 % of the supplemented group and 22.7 % of the control group complained about side-effects . CONCLUSION Weekly iron supplementation was logistically simpler and cheaper than daily supplementation but would have to be continued on a longer term basis in order to combat both anaemia and iron deficiency Evidence for the impact of micronutrient supplementation trials on  depression in women from developing countries is limited . This study examines this association and compares the impact of weekly versus daily combinations of micronutrient supplements on symptoms of depression . A r and omized , positive-controlled trial was conducted in Guatemala . A total of 459 women were assigned r and omly to 4 groups to receive weekly ( 5,000 or 2,800 microg ) or daily ( 400 or 200 microg ) folic acid ( FA ) plus iron , zinc and vitamin B-12 for 12 weeks . Depression was measured using the Center for Epidemiologic Studies -Depression 20-item Scale ( CES-D ) . A score = 16 was used as an indication of depression . The association between micronutrient status and depression was assessed using baseline data . Generalized linear regression models were used to assess treatment effects . The baseline mean CES-D score was 17.1 + /- 8.5 and the prevalence of depression was 49.3 % . Women in the lowest tertile of red blood cell folate ( RBC ) were 1.7 times more likely to be depressed than those in the highest tertile ( OR=1.71 ; 95 % CI : 0.91 , 3.18 ) . There were no associations between depression and serum folate , homocysteine , vitamin B-12 , hemoglobin , ferritin or zinc ( p > 0.05 ) . Mean depression scores decreased by 2.3 points post-intervention and depression decreased to 37.7 % , with no differences in degree of improvement by group ( p = 0.64 ) . Low RBC folate was associated with elevated symptoms of depression at baseline . Supplementation with FA-containing micronutrients may be equally efficacious in improving symptoms of depression when provided daily or weekly . Our findings that poor folate status may increase depression needs to be further investigated OBJECTIVE To examine the benefits of anemia prophylaxis in adolescent school.girls by weekly or daily iron-folate supplementation . DESIGN Prospect i ve study . SETTING Government girl schools of northeast Delhi . SUBJECTS 2088 subjects ( with hemoglobin greater than 7.9 g/dL ) , including 702 on daily and 695 on weekly iron-folate administration ; 691 girls served as controls .  RESULTS About 85 % girls were iron deficient out of which 49.3 % were anemic . Weekly administration took longer time to raise hemoglobin but was effective as well as practical . Plasma ferritin estimation in girls showed rise in level in both the treated groups . CONCLUSION Weekly administration of iron-folate was a practical and effective strategy for anemia prophylaxis in adolescent school girls In order to increase the intestinal absorption of iron whilst simultaneously minimising the side-effects and thus increasing compliance , once- or twice-weekly , instead of daily , iron supplementation has been widely recommended . In a r and omized , placebo-controlled , double-blind study in western Kenya , a tablet of ferrous dextran ( containing 60 mg elemental iron ) or an identical-looking placebo tablet was provided twice-weekly for 12 months to each child or adult investigated . At baseline each subject had a moderately low blood concentration of haemoglobin ( Hb ) . Initial Hb and serum ferritin ( SF ) concentrations were determined and each subject was tested for malarial and helminth infection and treated , if necessary , with the appropriate anthelminthic drug(s ) . Overall , 200 children ( aged 4 - 15 years ) and 129 adults ( aged 16 - 63 years ) completed the 12-month study . At baseline , 47.5 % of the children and 58.1 % of the adults were anaemic  , hookworm ( detected in 60.0 % of the children and 69.9 % of the adults ) was the most common helminth infection , and malaria was endemic . The results of bivariate analyses indicated that twice-weekly iron supplementation had no significant effect on blood Hb or SF concentrations , either in the children or the adults investigated . The results were confirmed in multiple linear-regression analyses , which revealed that the predictors of the final Hb concentration in the children investigated were age and infection , after enrollment , with Ascaris lumbricoides . Gender and the serum concentration of alpha-1-antichymotrypsin ( ACT ) at final follow-up were predictors of the final SF concentration in the children . In adults , the predictors of the final Hb concentration were gender and HIV infection , and the predictors of the final SF concentration were age and the serum concentration of ACT at the final follow-up . Twice-weekly iron supplementation did not increase Hb or iron stores in children or adults . Since compliance appeared to be high , this lack of effect may be the result of an inadequate dose of iron or of subjects who have deficiencies in micronutrients other than iron Objective : High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions . This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status . Design : School-based , grade -r and omized , intervention . Subjects and setting : In all , 1757 girls and 1859 boys , aged 12–15 y , in 24 Junior High Schools . Interventions : Weekly supplementation for 14 weeks with 60 mg iron and 250 μg folate ( Fe group ; n=978 ) , 10 000 IU vitamin A ( VA group ; n=970 ) or both ( VAFe group ; n=1042 ) to subjects in 15 schools , compared to subjects in nine other schools not receiving supplements  ( control ; n=626 ) . Results : The baseline anaemia prevalence ( Hb < 120 g/l ) in girls was 20 % ( prepubertal ) and 26 % ( pubertal ) , and in boys 24 % ( pre-pubertal ) and 11 % ( pubertal ) . Serum retinol concentrations were low ( < 1.05 μmol/l ) in 41 % of boys and 45 % of girls . The interventions did not increase haemoglobin concentrations . Serum retinol concentration of boys , but not girls , in the VA group increased ( 0.33 vs 0.07 μmol/l in controls ; P<0.01 ) . The risk factors for low serum retinol concentration were lower baseline serum retinol concentration ( OR 0.02–0.03 ) with , for girls , nightblindness at baseline ( OR 5.88 ) , and for boys , not receiving vitamin A ( OR control : 1.00 ; VA : 0.37 ; Fe : 0.77 ; VAFe : 0.34 ) and maternal illiteracy ( OR mother never attended school 1.00 , mother received any formal education 0.17–0.33 ) . Conclusions : Supplementation with vitamin A increased serum retinol concentration of boys . Iron supplementation did not change Hb . This appeared to be due to poor compliance , and partly related to side effects . Sponsorship : This study was funded by USAID through the OMNI Project To investigate the efficacy of two different iron supplements administered either on a weekly basis or during menstruation , a 16-week community experimental study was carried out among postmenarcheal female adolescent students in Kupang , East Nusa Tenggara , Indonesia . Forty eight students received a placebo tablet  weekly , 48 other students got an iron tablet weekly and 41 students took an iron tablet for four consecutive days during their menstruation cycle . All subjects were given deworming tablets before supplementation . Haemoglobin , serum ferritin , height , weight , mid-upper arm circumference and dietary intake were assessed before and after intervention . The supplementation contributed to a significant improvement in the iron status of the intervention groups compared to the placebo group ( P < 0.05 ) . In the menstruation group , the haemoglobin concentrations of the anaemic subjects improved significantly ( P < 0.05 ) while for the non-anaemic subjects , serum ferritin concentrations also increased significantly ( P < 0.05 ) . In the weekly group for anaemic and nonanaemic subjects , there was a significant increase in both haemoglobin and serum ferritin concentrations ( P < 0.05 ) . This study revealed that weekly supplementation of iron tablets continued for 16 weeks contributed a higher improvement to haemoglobin concentration , compared with supplementing iron tablets for four consecutive days during menstruation for four menstrual cycles . This suggests that weekly iron supplementation is preferable OBJECTIVES This work aims at study ing the effect of daily versus twice weekly long-term Fe supplementation on Fe absorption and status in Fe-deficient women . DESIGN AND METHODS The study design is a r and omized controlled open study carried out in the Internal Medicine Department , CHU de Clermont-Ferr and , France . Twenty-four young women participated in this study and were r and omized into two groups : Group 1 received 50 mg Fe daily , and group 2 received 50 mg Fe twice weekly for 3 months . On day 10 ( D10 ) and on day 90 ( D90 ) of Fe supplementation , blood sample s were obtained , and women received orally about 5 mg of 57Fe , and blood was sample d at different times over 24 h. The 57Fe absorption was evaluated by calculating the areas under the curves ( AUC ) . Fe and oxidative stress status were also assessed . RESULTS 57Fe absorption was similar in both groups on D10 but was greatly decreased in Group 1 and remained high in Group 2 on D90 . Fe status was more improved in Group 1 than in Group 2 . Oxidative stress status remained statistically unchanged . CONCLUSIONS Our study shows that daily Fe supplementation is able to correct an Fe deficiency much more than twice weekly Fe supplementation in young women BACKGROUND Maternal nutritional status before and during early pregnancy plays a critical role in fetal growth and development . The benefits of periconception folic acid ( FA ) supplementation in the prevention of neural tube defects is well recognized , but the evidence for preconception micronutrient interventions for improving pregnancy outcomes is limited . OBJECTIVE This study aim ed to evaluate whether preconception supplementation with weekly iron and folic acid ( IFA ) or multiple micronutrients ( MMs ) improves birth outcomes compared with FA alone . METHODS We recruited 5011 women of reproductive age in a double-blind , r and omized controlled trial in Vietnam and provided weekly supplements containing either 2800 μg FA , 60 mg Fe and 2800 μg FA ( IFA ) , or the same amount of FA and iron plus other MMs until they conceived ( n = 1813 ) . All pregnant women received daily IFA through delivery , and were followed up for birth outcomes , including birth weight , gestational age , preterm delivery and small for gestational age ( SGA ) . Group comparisons were done with the use of ANOVA or chi-square tests for both intention-to-treat ( n = 1599 ) and per- protocol analyses ( women consumed supplements ≥26 wk before conception ; n = 824 ) . Effect modification by baseline underweight or anemia status was tested with the use of generalized linear models . RESULTS The mean age of the women was 26 y , 30 % were underweight , and < 10 % were nulliparous . The groups were similar for most baseline characteristics . The mean ± SD duration of the preconception intervention was 33 ± 25 wk and compliance was high ( > 90 % ) . Infants born to the 3 groups of women did not differ ( P ≥ 0.05 ) on mean ± SD birth weight ( 3076.8 ± 444.5 g ) or gestational age ( 39.2 ± 2.0 wk ) , or prevalence of SGA ( 12 % ) , low birth weight ( 5 % ) and preterm delivery ( 10 % ) . There were no significant differences in women who consumed supplements ≥26 wk before conception or by baseline underweight or anemia . CONCLUSION Weekly supplementation with MMs or IFA before conception did not affect birth outcomes compared with FA in rural Vietnamese women . The trial was registered at clinical trials.gov as NCT01665378 OBJECTIVE To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia in adolescent Nepalese girls . DESIGN R and omized controlled trial . SETTING A Government Girl School in Dharan , Nepal , an urban foothill town that is 305 m above sea level . SUBJECTS Consecutive healthy adolescent girls ( n = 209 , median age 15 years ) r and omized to 3 groups matched for age , anthropometry , and personal and sociodemographic characteristics . Of 209 subjects , 181 completed the trial . Two girls had adverse reactions to treatment and were excluded . INTERVENTION Group A ( n = 70 ) received a 350-mg ferrous sulfate and 1.5-mg folic acid combination once daily for 90 to 100 days . Group B ( n = 67 ) received the tablet under supervision once a week for 14 weeks . Group C ( n = 72 ) did not receive any drugs . OUTCOME VARIABLE Presupplementation and postsupplementation differences in prevalence of anemia and change in hematocrit . RESULTS Prevalence of anemia ( defined as hematocrit < 36 % ) declined from 68.6 % and 70.1 % in groups A and B to 20 % and 13.4 % , respectively , postsupplementation ( P<.001 ) , whereas the prevalence in group C changed little ( 68.1 % to 65.3 % , P = .81 ) . There was a significant rise in the mean hematocrit of both supplemented groups ( group A , 32.9 % + /- 3.5 % to 41.0 % + /- 5.6 % , P<.001 ; group B , 33.2 % + /- 3.6 % to 40.4 % + /- 4.9 % , P<.001 ) but no appreciable change in controls ( 34.2 % + /- 2.9 % to 34.1 % + /- 3.3 % , P = .91 ) . Net change in mean hematocrit in both the supplementation groups was comparable ( P = .57 ) . CONCLUSIONS The prevalence of anemia in adolescent Nepalese girls is high . Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anemia in adolescent girls OBJECTIVES To obtain baseline data on hemoglobin ( Hb ) levels of adolescent girls belonging to the low-socio-economic groups ; investigate the comparative efficacy of once ' weekly ' and ' daily ' administration of iron-folate tablets with respect to impact on the Hb levels ; and find out the effect of added ascorbic acid supplementation on the efficacy of iron-folate administration with respect to increment in Hb levels . DESIGN R and omized experimental . SETTING Adolescent girls of poor communities in urban areas of Delhi and rural parts of Bharatpur ( Rajasthan ) . METHODS The baseline investigations included measurements of height , weight , and Hb levels . The Hb levels of the participating subjects were measured again after 3 months and 6 months of supplementation . RESULTS 61.9 % of the subjects in the urban and 85.4 % in the rural area were anemic . The response of Hb levels to daily iron/folate supplementation was better in comparison to once-weekly supplementation . The increment in Hb levels of subjects due to addition of vitamin C to iron/folate supplementation was more than that with supplementation of iron/folate alone . CONCLUSIONS Considering compliance , feasibility and cost-factors , a public-health approach consisting of once-weekly distribution of iron/folate supplementation through schools and welfare centers is better and can be recommended as an appropriate strategy for combating anemia in adolescent girls of poor communities in developing countries like India The present study examined whether long-term supplementation with once- and twice-weekly multiple micronutrients ( MMN-1 and MMN-2 ) can improve Hb and micronutrient status more than twice-weekly Fe-folic acid ( IFA-2 ) supplementation in non-anaemic adolescent girls in Bangladesh . An equal number of 324 rural schoolgirls aged 11 - 17 years were given MMN-1 or MMN-2 or IFA-2 supplements for 52 weeks in a r and omised , double-blind trial . Blood sample s were collected at baseline , and at 26 and 52 weeks of supplementation . The girls receiving IFA-2 supplements were more likely to be anaemic than the girls receiving MMN-2 supplements for 26 weeks ( OR 5·1 , 95 % CI 1·3 , 19·5 ; P = 0·018 ) . All three supplements reduced Fe deficiency effectively . Both the MMN-1 and MMN-2 groups showed significantly greater improvements in vitamins A , B(2 ) and C status than the girls in the IFA-2 group , as might be expected . Receiving a MMN-1 supplement was found to be less effective than MMN-2 supplement in improving Fe , vitamins A , B(2 ) and folic acid status . Receiving micronutrient supplements beyond 26 weeks showed little additional benefit in improving micronutrient status . In conclusion , given twice-weekly for 26 weeks , MMN supplements can improve micronutrient status effectively with no significant increase in Hb concentration compared with IFA supplements in non-anaemic Bangladeshi adolescent girls . However , it significantly reduces the risk of anaemia . Before any recommendations can be made , further research , including into cost-effectiveness , is needed to see whether MMN supplementation has any additional longer-term health benefits over that of IFA supplementation in this population Objective : Our aim was to determine if a once-a-week folic acid supplement increases women 's red blood cell folate to concentrations ( > 905 nmol/l ) that are associated with a low risk of bearing a child with a neural tube defect . Design : R and omized control trial . Setting : General community . Subjects : In total , 114 nonpregnant women ( 18–40 y ) volunteers , with red blood cell folate concentrations between 295 and 905 nmol/l at screening . Interventions : Women were r and omized to receive a once-a-week 2800 μg folic acid supplement , a daily 400 μg folic acid supplement or a daily placebo for 12 weeks . Results : The mean ( 95 % CI ) red blood cell folate concentrations increased during the 12-week intervention from 608 ( 553–668 ) to 900 ( 828–978 ) in the weekly folic acid group ( P<0.05 ) and from 615 ( 560–677 ) to 1053 ( 957–1158 ) nmol/l in the daily group ( P<0.05 ) during the trial . At week 12 , 49 % of women ingesting the weekly folic acid supplement had red blood cell folate concentrations greater than 905 nmol/l compared to 74 % of women ingesting the daily supplement . Conclusions : A once-a-week 2800 μg folic acid supplement can increase women 's red blood cell folate to concentrations associated with a reduced risk of bearing a child with a neural tube defect , but is less effective than a 400 μg daily supplement . Use of a weekly folic acid supplement over at least 12 weeks before conception by women of child-bearing age may prevent neural tube defects . Funding : The Otago Medical Research Foundation ( Laurenson Award ) . Healtheries ( New Zeal and ) provided the supplements The goal of the study was to determine whether the addition of vitamins A and C and extra folate to the commonly distributed iron-folate supplement administered on a weekly basis would result in improved iron status in anaemic and non-anaemic female adolescents . Subjects ( n=84 ) were selected if their haemoglobin concentration in venous blood was < = 140g/L. Subjects were r and omly allocated into 2 groups . One group received 60 mg iron , 500 m g folic acid , 20 000 IU vitamin A and 60 mg vitamin C weekly , while the other group received 60 mg iron and 250 m g folic acid weekly for a period of 5 weeks . Before and after treatment , haemoglobin , serum ferritin and body height and weight were determined . All subjects received anthelmintic drugs before supplementation . A complete data set was obtained from 42 young women in the group supplemented with  iron , folic acid , vitamin A and vitamin C and from 40 young women in the group supplemented with iron and folic acid . Haemoglobin , mean cell volume and serum ferritin increased significantly in both groups ( p<0.05 ) . Among anaemic adolescents , the rise in haemoglobin concentration in the multisupplement group was higher than that in the iron folate group . The result confirms that weekly supplementation is effective in improving iron status in a short time ( 5 weeks ) and that supplementation with vitamins as well as iron results in an additional improvement in haemoglobin concentration We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga , Tanzania . Supplementation led to a significantly greater increase in serum ferritin compared with the control group ( + 15.6 microg/l vs. 8.6 microg/l ) ( P = 0.002 ) but there was no significant difference in change in haemoglobin . Children given iron showed a significantly greater weight gain than controls ( + 2.4 kg vs. + 1.4 kg ) ( P = 0.03 ) . Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency A 24-week r and omized double blind intervention trial was conducted on adult female tea pluckers from an estate in Bangladesh to investigate the impact of iron supplementation and anthelmintic treatment on changes in ferritin and haemoglobin levels as well as on prevalence and intensity of helminth infections . A total of 553 women were r and omly assigned to 1 of 4 intervention groups : group 1 received iron supplementation on a weekly basis , group 2 received anthelmintic treatment at the beginning and half way through the trial , group 3 received both iron supplementation as group 1 and anthelmintic treatment as group 2 , and group 4 was a control group and received placebos for both iron supplementation and anthelmintic treatment .  Prevalence and intensity of helminth infections ( egg counts/g stool ) of Ascaris lumbricoides , Trichuris trichiura and hookworms significantly fell in the 2 groups receiving anthelmintic treatment and there were some reductions in the 2 groups not receiving anthelminthic treatment . Haemoglobin and haematocrit concentrations increased significantly in the iron supplemented groups with smaller increases in the anthelmintic only group . All women showed a decrease in serum ferritin levels post-trial with greater losses in the 2 dewormed groups . Significant negative associations were found between hookworm egg counts and ferritin levels and Trichuris trichiura egg counts and haemoglobin concentration A blind r and omized trial was conducted in a low-income community in the city of Recife , Pernambuco , Brazil , with 193 anemic ( Hb < 12 mg/dl ) and " menstruating " women ( age range : 15 - 45 years ) to compare daily and weekly doses of ferrous sulfate ( 60 mg elemental iron ) and treatment compliance . Blood sample s were taken from 484 women to determine hemoglobin levels before and after the trial and mean corpuscular volume ( MCV ) at end of treatment . After 12 weeks ' follow-up , 150 women completed the trial , 79 on the alternative weekly regimen and 71 on the conventional daily regimen .  Mean corpuscular hemoglobin concentrations ( MCHC ) prior to treatment were 10.52 g/dl ( DP=1.13 ) and 10.72 g/dl ( DP=0.92 ) , respectively , for the alternative and conventional regimens . After the intervention they were 11.83 g/dl ( DP=0.97 ) for the weekly regimen and 11.62 g/dl ( DP=1.39 ) for the daily one . The alternative regimen was better accepted than the conventional one . There was no significant difference ( p=0.22 ) between differences in the mean values of the two regimens , although the cure rate was higher after the alternative treatment . The study concluded that the weekly regimen was no less effective than daily treatment Previous short-term supplementation studies showed no additional hematologic benefit of multiple micronutrients ( MMN ) compared with iron + folic acid ( IFA ) in adolescent girls . This study examines whether long-term once- or twice-weekly supplementation of MMN can improve hemoglobin ( Hb ) and micronutrient status more than twice-weekly IFA supplementation in anemic adolescent girls in Bangladesh . Anemic girls ( n = 324 ) aged 11 - 17 y attending rural schools were given once- or twice-weekly MMN or twice-weekly IFA , containing 60 mg iron/dose in both supplements , for 52 wk in a r and omized double-blind trial . Blood sample s were collected at baseline and 26 and 52 wk . Intent to treat analysis showed no significant difference in the Hb concentration between treatments at either 26 or 52 wk . However , after excluding girls with hemoglobinopathy and adjustment for baseline Hb , a greater increase in Hb was observed with twice-weekly MMN at 26 wk ( P = 0.045 ) . Although all 3 treatments effectively reduced iron deficiency , once-weekly MMN produced significantly lower serum ferritin concentrations than the other treatments at both 26 and 52 wk . Both once- and twice-weekly MMN  significantly improved riboflavin , vitamin A , and vitamin C status compared with IFA . Overall , once-weekly MMN was less efficacious than twice-weekly MMN in improving iron , riboflavin , RBC folic acid , and vitamin A levels .  Micronutrient supplementation beyond 26 wk was likely important in sustaining improved micronutrient status . These findings highlight the potential usefulness of MMN intervention in this population and have implication s for programming A r and omized controlled trial in KwaZulu-Natal ( South Africa ) of 428 primary -school pupils ( stratified into 6 groups by age , sex and intervention ) measured the effect of different anthelmintic treatments and iron supplementation regimens provided twice at 6-monthly intervals for 1 year ( 1996/97 ) . Half the pupils received iron supplementation ( ferrous fumarate 200 mg weekly for 10 weeks ) . Pupils received 2 anthelmintic regimens , either ( i ) albendazole 400 mg plus praziquantel 40 mg/kg or ( ii ) albendazole 400 mg on 3 consecutive days plus praziquantel 40 mg/kg or ( iii ) placebo . Baseline prevalences of Ascaris 55.9 % , Trichuris 83.6 % , hookworm spp . 59.4 % , were reduced after 12 months for single-dose albendazole treatment to Ascaris 17.4 % ( P < 0.005 ) , Trichuris 61.5 % ( NS ) , hookworm spp . 0 % ( P < 0.005 ) , and for triple-dose albendazole treatment to Ascaris 14.8 % ( P < 0.005 ) , Trichuris 25.0 % ( P < 0.01 ) , hookworm 0 % ( P < 0.005 ) . Schistosoma haematobium 43.4 % was reduced among treated groups to 8.3 % ( P < 0.005 ) . There were no significant changes in the anthropometry of the different treatment groups at either 6 or 12 months post treatment . Twelve months after treatment there was a significant increase in haemoglobin levels ( P = 0.02 ) among pupils receiving triple-dose albendazole , praziquantel and ferrous fumarate ; pupils receiving no anthelmintic treatment showed a significant decrease as did pupils who received triple-dose albendazole and praziquantel but no iron . Regular 6-monthly anthelmintic treatment significantly reduced the prevalence of Ascaris , hookworm spp . and S. haematobium infections ( P < 0.05 ) . Triple-dose treatment for Trichuris was significantly more effective than a single dose of albendazole 400 mg ( P = 0.002 ) . In areas with schistosomiasis , hookworm infection and high prevalence of Trichuris infection , combination treatment with praziquantel , triple-dose albendazole , plus iron supplementation , is likely to improve pupils ' health and haemoglobin levels BACKGROUND We undertook this study to compare the effectiveness and safety of antenatal daily and weekly supplementation with iron , folic acid , and vitamin B(12 ) in healthy , pregnant women who were not anemic at gestational week 20 . METHODS Women with singleton pregnancies and blood hemoglobin ( Hb ) > 115 g/L at gestational week 20 ( equivalent to 105 g/L at sea level ) were r and omly assigned to two groups , one consuming one tablet containing 60 mg iron , 200 mug folic acid and 1 mug vitamin B(12 ) daily ( DS , n = 56 ) ; the other consuming two tablets once weekly ( WS , n = 60 ) . Blood Hb and serum ferritin concentrations were measured every 4 weeks from weeks 20 to 36 , and pregnancy outcomes were evaluated . RESULTS Mild anemia and hypoferritinemia throughout pregnancy occurred less frequently in DS than WS . None of the 116 women had Hb concentrations < 103 g/L at any evaluation point . In contrast , hemoconcentration ( Hb > 145 g/L ) from gestational week 28 onwards occurred in 11 % in DS and 2 % in WS . We observed ex post facto that hemoconcentration at gestational week 28 was associated with a significantly higher relative risk of low birth weight ( RR 6.23 , 95 % CI 1.46 - 26.57 ) and premature delivery ( RR 7.78 , 95 % CI 1.45 - 24.74 ) . CONCLUSIONS In women who were nonanemic at gestational week 20 , both schemes ( DS and WS ) prevented the occurrence of Hb levels < 100 g/L. DS women had a higher incidence of hemoconcentration . Hemoconcentration was associated with increased risk of low birth weight and premature delivery OBJECTIVE To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers . DESIGN Sixty schools were r and omly assigned to two groups : in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid ; in the other 30 schools  no iron tablets were given . All children were dewormed and given vitamin A before the study began . The haemoglobin concentration of up to 20 r and omly selected children in each school was estimated before and 2 weeks after the end of treatment . SETTING Rural community schools in Kolondieba district of Mali . SUBJECTS Some 1113 schoolchildren aged 6 - 19 years with a mean of 11.4 years . RESULTS The haemoglobin concentration of treated children rose on average by 1.8 g l(-1 ) and the prevalence of anaemia fell by 8.2 % ; in untreated children the haemoglobin concentration fell by an average of -2.7 g l(-1 ) and the prevalence of anaemia rose by 9.4 % . The fall in haemoglobin concentration among untreated girls of -4.0 g l(-1 ) was greater than in untreated boys ( -0.3 g l(-1 ) ) . CONCLUSIONS Weekly iron tablets given by teachers prevented a general fall in the haemoglobin concentrations of untreated children , and led to a small but statistically significant rise among treated children . Young children benefited more than children aged > or=12 years , and girls benefited more than boys This experimental study was design ed to investigate the effects of daily versus intermittent iron supplementation on iron status of high school girls in Zahedan and Rasht cities in 1996 - 1997 . The subjects were selected r and omly from among students of grade s 1 - 3 of four high schools in each city .  Anemia was determined by measuring hematological indices . 260 anemic and a similar number of non-anemic subjects of 4 high schools were selected and allocated r and omly to 4 treatment groups . During a 3-month period , the test groups were given 150 mg ferrous sulfate tablets ( 50 mg Fe ) . Subjects in group 1 received a daily dose , groups 2 & 3 received twice or once weekly doses respectively . The control group received no iron supplement . For these subjects , in addition to hematological indices biochemical iron indices were measured in the beginning and at the end of the study . The increases in hemoglobin concentration in anemic subjects were not significantly different among supplemented groups but were different from the control group ( p < 0.00001 ) . Among anemic subjects , changes in serum ferritin levels in 3 supplemented groups were significantly different from the control group . Serum ferritin in Group 1 was also increased to a greater extent than groups 2 and 3 ( P < 0.00001 ) . It is concluded that over the study period a weekly iron dose was as effective as a daily dose in treating anemia but the daily dose was more effective in improving iron stores than a weekly dose in the short run BACKGROUND Up to 25 % of adolescent girls in the USA are iron deficient . This double-blind , placebo-controlled clinical trial assessed the effects of iron supplementation on cognitive function in adolescent girls with non-anaemic iron deficiency . METHODS 716 girls who enrolled at four Baltimore high schools were screened for non-anaemic iron deficiency ( serum ferritin < or = 12 micrograms/L with normal haemoglobin ) . 98 ( 13.7 % ) girls had non-anaemic iron deficiency of whom 81 were enrolled in the trial . Participants were r and omly assigned oral ferrous sulphate ( 650 mg twice daily ) or placebo for 8 weeks . The effect of iron treatment was assessed by question naires and haematological and cognitive tests , which were done before treatment started and repeated after the intervention . We used four tests of attention and memory to measure cognitive functioning . Intention-to-treat and per- protocol analyses were done . FINDINGS Of the 81 enrolled girls with non-anaemic iron deficiency , 78 ( 96 % ) completed the study ( 39 in each group ) . Five girls ( three control , two treatment ) developed anaemia during the intervention and were excluded from the analyses . Thus , 73 girls were included in the per- protocol analysis . Ethnic distribution , mean age , serum ferritin concentrations , haemoglobin concentrations , and cognitive test scores of the groups did not differ significantly at baseline . Postintervention haematological measures of iron status were significantly improved in the treatment group ( serum ferritin 27.3 vs 12.1 micrograms/L , p < 0.001 ) . Regression analysis showed that girls who received iron performed better on a test of verbal learning and memory than girls in the control group ( p < 0.02 ) . INTERPRETATION In this urban population of non-anaemic iron-deficient adolescent girls , iron supplementation improved verbal learning and memory A r and omized , placebo-controlled , double-blind trial was carried out in 1994 - 96 among 231 children and 181 adults in order to determine the effects of iron on reinfection rates and intensities of hookworm  , Ascaris lumbricoides , Trichuris trichiura and Schistosoma mansoni . Adults given 60 mg elemental iron twice-weekly for 12 months had significantly lower reinfection rates of A. lumbricoides ( 16.7 % vs 31.9 % , P = 0.046 ) , T. trichiura ( 6.9 % vs 20.6 % , P = 0.03 ) and S. mansoni ( 38.3 % vs 61.8 % , P = 0.008 ) compared to adults given placebo . In contrast , adults allocated to iron had a significantly higher reinfection rate of hookworm at the 4-month examination ( 11.1 % vs 0 % , P = 0.009 ) , but the difference was not significant at 8- and 12-month follow-up examinations . Iron supplementation had no effect on reinfection intensities in adults . Surprisingly , iron supplementation had no effect on either reinfection rates or intensities in children . Multiple logistic regression analyses controlling for baseline infection status confirmed the effect in adults of iron on A. lumbricoides , T. trichiura and S. mansoni reinfection rates . The effect is suggested to be due to reduced risk behaviour , to improved immune function or to unfavourable host gut conditions caused by an increased oxidative stress . In each case , the lack of effect in children remains to be explained . In contrast , iron supplementation apparently was short-lived in favour of hookworm infection , an effect that needs further clarification . The findings suggest that iron supplementation has a role to play in helminth control programmes and that intraluminal factors may contribute to the regulation of some helminth infections Background Weekly iron – folic acid supplementation in small-scale research trials and as administered in institutions has been demonstrated to be effective in reducing anemia in adolescent girls . Objective To assess the effectiveness of weekly iron – folic acid supplementation in a large-scale project in reducing the prevalence of anemia in adolescent girls . Methods The project provided weekly iron – folic acid tablets , family life education , and deworming tablets every 6 months to 150,700 adolescent school girls and non-schoolgirls of a total district population of 3,647,834 . Consumption of the iron – folic acid tablets was supervised for schoolgirls but not for non-schoolgirls . Hemoglobin levels were assessed in a r and om sample of non-schoolgirls at 6 and 12 months and schoolgirls at 6 months . The effect of supplementation on the prevalence of anemia and the compliance rate were assessed over a 4-year period . Results In 4 years , the overall prevalence of anemia was reduced from 73.3 % to 25.4 % . Hemoglobin levels and anemia prevalence were influenced significantly at 6 months . No difference in the impact on hemoglobin or anemia prevalence was observed between supervised and unsupervised girls . Counseling on the positive effects of regular weekly iron – folic acid intake contributed to a high compliance rate of over 85 % . The cost of implementation was US$ 0.36 per beneficiary per year . Conclusions Weekly iron – folic acid supplementation combined with monthly education sessions and deworming every 6 months is cost-effective in reducing the prevalence of anemia in adolescent girls . Appropriate counseling , irrespective of supervision , is critical for achieving positive outcomes Background Iron deficiency and iron-deficiency anaemia are associated with oxidative stress , but their role is largely unclear . Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans . Aims This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin , and decreasing oxidative stress among iron-deficient female adolescents in Gaza , Palestine . Methods A total 131 iron-deficient female adolescents were recruited and allocated r and omly into 3 different groups . The iron supplementation group ( A ) received 200 mg of ferrous fumarate weekly during the 3-month intervention , the iron supplementation with nutrition education group ( B ) received iron supplements with nutrition education sessions , and the control group ( C ) did not receive any intervention . The levels of haemoglobin , ferritin and malonyl dialdehyde were measured at baseline , after 3 months ( at which point the intervention was stopped ) , and then 3 months later . Trial registration number : ACTRN12618000960257 . Results Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage ( 3 months after stopping the intervention ) , iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased . In Group A , haemoglobin , ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention . No changes were seen in Group C. Conclusions A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine
BACKGROUND Anaemia is a condition in which the number of red blood cells is insufficient to meet physiologic needs ; it is caused by many conditions , particularly iron deficiency .
Traditionally , daily iron supplementation has been a st and ard practice for preventing and treating anaemia .
However , its long-term use has been limited , as it has been associated with adverse side effects such as nausea , constipation , and teeth staining .
Intermittent iron supplementation has been suggested as an effective and safer alternative to daily iron supplementation for preventing and reducing anaemia at the population level , especially in areas where this condition is highly prevalent .
OBJECTIVES To assess the effects of intermittent oral iron supplementation , alone or in combination with other nutrients , on anaemia and its associated impairments among menstruating women , compared with no intervention , a placebo , or daily supplementation .