Elimination of Iron Deficiency Anemia and Soil Transmitted Helminth Infection: Evidence from a Fifty-four Month Iron-Folic Acid and De-worming Program

Background: intermittent iron-folic acid supplementation and regular de-worming are effective initiatives to reduce anemia,iron deficiency,iron deficiency anemia,and soil transmitted helminth infections in women of reproductive age. however,few studies have assessed the long-term effectiveness of population-based interventions delivered in resource-constrained settings. methodology/principal findings: the objectives were to evaluate the impact of weekly iron-folic acid supplementation and de-worming on mean hemoglobin and the prevalence of anaemia,iron deficiency,and soil transmitted helminth infection in a rural population of women in northern vietnam and to identify predictive factors for hematological outcomes. a prospective cohort design was used to evaluate a population-based supplementation and deworming program over 54 months. the 389 participants were enrolled just prior to commencement of the intervention. after 54 months 76% (95% ci [68%,84%]) were taking the iron-folic acid supplement and 95% (95% ci [93%,98%]) had taken the most recently distributed deworming treatment. mean hemoglobin rose from 122 g/l (95% ci [120,124]) to 131 g/l (95% ci [128,134]) and anemia prevalence fell from 38% (95% ci [31%,45%]) to 18% (95% ci [12%,23%]); however,results differed significantly between ethnic groups. iron deficiency fell from 23% (95% ci [17%,29%]) to 8% (95% ci [4%,12%]),while the prevalence of iron deficiency anemia was reduced to 4% (95% ci [1%,7%]). the prevalence of hookworm infection was reduced from 76% (95% ci [68%,83%]) to 11% (95% ci [5%,18%]). the level of moderate or heavy infestation of any soil-transmitted helminth was reduced to less than 1%. conclusions/significance: population-based interventions can efficiently and effectively reduce anemia and practically eliminate iron deficiency anemia and moderate to heavy soil transmitted helminth infections,maintaining them below the level of public health concern. © 2013 casey et al.