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Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area


V Mwanakasale
S Siziya
J Mwansa
A Koukounari
A Fenwick

Abstract



Aim: To study impact of once weekly iron supplementation on praziquantel cure rate, Schistosoma haematobium reinfection, and haematological parameters in pupils aged between 9 and 15 years of age in Nchelenge district, Zambia.
Methods: Pupils in the intervention group received once weekly dose of ferrous sulphate at 200mg while those in the control received once weekly vitamin C at 100mg for up to 9 months. Both study groups received a single dose of praziquantel at baseline.
Results: S haematobium reinfection intensity was significantly lower in boys in the intervention group than in boys in the control group at 6 months (P<0.001) and 9 months (P<0.001) of supplementation. Significantly lower S haematobium reinfection intensity was found in girls in the intervention group than in girls in the control group only at 6 months of supplementation (P=0.018). Boys in the intervention group were 42% (Adjusted Risk Ratio =0.58, 95% confidence interval 0.39, 0.86) less likely to be reinfected with S haematobium than in the control group at 6 months follow up.
Conclusion: Once weekly iron supplementation can decrease S haematobium reinfection after 6 months and should be incorporated into school based schistosomiasis control programs in highly endemic areas.
Clinical trials.gov identifier: NCT 00276224, sponsored by DBL-Institute for Health Research and Development, Denmark.

Malawi Medical Journal Vol. 21 (1) 2009: pp. 12-18

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eISSN: 1995-7262
print ISSN: 1995-7270