Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: Double blind, placebo controlled study

R. J. Stoltzfus, J. D. Kvalsvig, H. M. Chwaya, A. Montresor, M. Albonico, J. M. Tielsch, L. Savioli, E. Pollitt

Research output: Contribution to journalArticle

Abstract

Objective: To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design: Double blind, placebo controlled randomised factorial trial of iron supplementation and anthelmintic treatment. Setting: Community in Pemba Island, Zanzibar. Participants: 614 preschool children aged 6-59 months. Main outcome measures: Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. Results: Before intervention, anaemia was prevalent and severe, and geohelminth infections were prevalent and light - Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale. Iron supplementation also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P = 0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations <90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean value), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura, but not by hookworms. Mebendazole increased development scores by 0.4 (-0.3 to 1.1) points on the motor scale and 0.3 (-0.3 to 0.9) points on the language scale. Conclusions: Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration <90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.

Original languageEnglish (US)
Pages (from-to)1389-1393
Number of pages5
JournalBMJ (Online)
Volume323
Issue number7326
StatePublished - Dec 15 2001

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Language Development
Anthelmintics
Tanzania
Preschool Children
Iron
Placebos
Mebendazole
Hemoglobins
Therapeutics
Anemia
Indian Ocean Islands
Ascaris lumbricoides
Trichuris
Ancylostomatoidea
Motor Skills
Plasmodium falciparum
Infection
Growth and Development
Islands
Malaria

ASJC Scopus subject areas

  • Medicine(all)

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Stoltzfus, R. J., Kvalsvig, J. D., Chwaya, H. M., Montresor, A., Albonico, M., Tielsch, J. M., ... Pollitt, E. (2001). Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: Double blind, placebo controlled study. BMJ (Online), 323(7326), 1389-1393.

Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar : Double blind, placebo controlled study. / Stoltzfus, R. J.; Kvalsvig, J. D.; Chwaya, H. M.; Montresor, A.; Albonico, M.; Tielsch, J. M.; Savioli, L.; Pollitt, E.

In: BMJ (Online), Vol. 323, No. 7326, 15.12.2001, p. 1389-1393.

Research output: Contribution to journalArticle

Stoltzfus, RJ, Kvalsvig, JD, Chwaya, HM, Montresor, A, Albonico, M, Tielsch, JM, Savioli, L & Pollitt, E 2001, 'Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: Double blind, placebo controlled study', BMJ (Online), vol. 323, no. 7326, pp. 1389-1393.
Stoltzfus, R. J. ; Kvalsvig, J. D. ; Chwaya, H. M. ; Montresor, A. ; Albonico, M. ; Tielsch, J. M. ; Savioli, L. ; Pollitt, E. / Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar : Double blind, placebo controlled study. In: BMJ (Online). 2001 ; Vol. 323, No. 7326. pp. 1389-1393.
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T1 - Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar

T2 - Double blind, placebo controlled study

AU - Stoltzfus, R. J.

AU - Kvalsvig, J. D.

AU - Chwaya, H. M.

AU - Montresor, A.

AU - Albonico, M.

AU - Tielsch, J. M.

AU - Savioli, L.

AU - Pollitt, E.

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N2 - Objective: To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design: Double blind, placebo controlled randomised factorial trial of iron supplementation and anthelmintic treatment. Setting: Community in Pemba Island, Zanzibar. Participants: 614 preschool children aged 6-59 months. Main outcome measures: Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. Results: Before intervention, anaemia was prevalent and severe, and geohelminth infections were prevalent and light - Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale. Iron supplementation also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P = 0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations <90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean value), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura, but not by hookworms. Mebendazole increased development scores by 0.4 (-0.3 to 1.1) points on the motor scale and 0.3 (-0.3 to 0.9) points on the language scale. Conclusions: Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration <90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.

AB - Objective: To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design: Double blind, placebo controlled randomised factorial trial of iron supplementation and anthelmintic treatment. Setting: Community in Pemba Island, Zanzibar. Participants: 614 preschool children aged 6-59 months. Main outcome measures: Development of language and motor skills assessed by parental interview before and after treatment in age appropriate subgroups. Results: Before intervention, anaemia was prevalent and severe, and geohelminth infections were prevalent and light - Plasmodium falciparum infection was nearly universal. Iron supplementation significantly improved iron status, but not haemoglobin status. Iron supplementation improved language development by 0.8 (95% confidence interval 0.2 to 1.4) points on the 20 point scale. Iron supplementation also improved motor development, but this effect was modified by baseline haemoglobin concentrations (P = 0.015 for interaction term) and was apparent only in children with baseline haemoglobin concentrations <90 g/l. In children with a baseline haemoglobin concentration of 68 g/l (one standard deviation below the mean value), iron treatment increased scores by 1.1 (0.1 to 2.1) points on the 18 point motor scale. Mebendazole significantly reduced the number and severity of infections caused by Ascaris lumbricoides and Trichuris trichiura, but not by hookworms. Mebendazole increased development scores by 0.4 (-0.3 to 1.1) points on the motor scale and 0.3 (-0.3 to 0.9) points on the language scale. Conclusions: Iron supplementation improved motor and language development of preschool children in rural Africa. The effects of iron on motor development were limited to children with more severe anaemia (baseline haemoglobin concentration <90 g/l). Mebendazole had a positive effect on motor and language development, but this was not statistically significant.

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