Effects of an iron supplementation trial on the Fe status of Thai schoolchildren

Oct 6, 2026

A double-blind clinical trial evaluated how iron supplementation affects iron status in 9-to 11-year-old Thai children across sixteen schools in Chon Buri. Among 2268 children receiving albendazole, iron or placebo tablets were provided without knowledge of Fe status. After 16 weeks, treatment significantly improved hemoglobin and serum ferritin while reducing free erythrocyte protoporphyrin, with changes exceeding the albendazole-only control group. Albendazole alone also shifted several Fe indicators significantly.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

METHODS

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# Effects of an iron supplementation trial on the Fe status of Thaischoolchildren BY PHONGJAN HATHIRAT¹,AREE VALYASEVI²,NITTAYA J.KOTCHABHAKDI¹,NIPA ROJROONGWASINKUL²AND ERNESTO POLLITT³* ¹Department of Pediatrics,Faculty of Medicine,Ramathibodi Hospital,Mahidol University,Bangkok,Thailand ²Institute of Nutrition,Mahidol University,Bangkok,Thailand 3Department of Pediatries,School of Medicine and Program of International Nutrition,University of California,Davis,California,USA (Received I November 1990-Accepted 1 August 1991) A double-blind clinical trial was conducted among 9-to 11-year-old children in sixteen schools in theChon Buri province of Thailand to assess the effects of an iron supplement combined with ananthelminthic agent (i.e.albendazole).In addition to the albendazole,Fe or placebo tablets weredistributed to 2268 children enrolled in grades three to five without knowledge of the Fe status of thechildren.Criteria for case inclusion were:(a)absence of AE Bart's or haemoglobin(Hb)H disease,(b)absence of abnormal Hb EE,and(c)age,108-144 months.The results showed a significantimprovement in the Fe status of the children after 16 weeks of treatment.The increments were:Hb from124 to 128 g/l,serum ferritin from 3454 to 10472μg/l,transferrin saturation from 2409 to 3505%;free erythrocyte protoporphyrin decreased from 4447 to 281-4μg/l erythrocytes.These changes weresignificantly greater than in the control group that received only the anthelminthic agent.However,theadministration of albendazole only also resulted in significant changes in the same Fe indicators. Iron supplementation:Thai schoolchildren Iron-deficiency anaemia(IDA),a complex public health problem in Thailand,is determinedin varying degrees by the interaction of intestinal parasites and low intake andbioavailability of Fe.Among men,the prevalence of anaemia in Thailand has beenestimated as twenty-five cases per 100,and among women and children,forty-five cases per100(Na-Nakorn,1979).Vegetables are thought to be the major dietary Fe source(Areekulet al.1972).Hookworm among schoolchildren in Bangkok and north-east Thailand hasranged from less than 1%in the city to 90%in the rural area.An estimated 58%of therural children have had a worm infestation resulting in a loss of between 2·7 and 27mlblood/d through the gastrointestinal tract. Among the Thai people there is also a high prevalence of haemoglobin(Hb)disordersand heterozygote carrier states (i.e.traits;Na-Nakorn et al.1956;Wasi et al.1969).Thetreatment of anaemia by Fe in thalassaemia diseases increases the risk of Fe overload(Weatherall &Clegg,1981). One approach in the treatment of IDA in Thailand has been the fortification of a suitablefood item.A fish sauce was,as a condiment,a successful vehicle for Fe³+EDTA,asobserved by the significant changes in the haemotological outcome variables(Garby &Areekul,1974).However,the public health benefits derived from its widespread application *For reprints. https:/doiorg/10.1079/BN19920081 Publshed onlne by ambrldge University Press P.HATHIRAT AND OTHERS are questionable since some fish sauces are prepared at home and purchased ones are notalways fortified with Fe. An alternative strategy,not devoid of implementation problems,is Fe supplementation.The following report is of a double-blind clinical trial designed to test the effects of an Fesupplement in the form of ferrous sulphate administered to 9-to 11-year-old children insixteen schools in the Chon Buri province of Thailand.The treatment also includedalbendazole,an anthelminthic agent.The Fe or placebo and the albendazole weredistributed without knowledge of the Fe status of the children.In addition to the issue ofeffectiveness of treatment,the study addressed the following specific questions relevant topublic health and policy. 1 Is the risk of Fe deficiency associated with social and economic status? 2 Are there any side effects to an Fe supplementation intervention among scho

FAQs

How was the double-blind trial designed in this study?

Sixteen Thai schools participated, and 2268 children received albendazole plus either iron tablets or placebo without knowing their Fe status. Physical and haematology measurements were taken before and after the intervention.

What was the main outcome after 16 weeks of treatment?

Iron supplementation significantly improved children’s Fe status, including increases in hemoglobin and serum ferritin and a decrease in free erythrocyte protoporphyrin.

Did albendazole alone have an effect on iron indicators?

Yes. Administration of albendazole only produced significant changes in several Fe indicators, though the combination with iron produced greater improvements than the control group.

Oct 6, 2026

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