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Objective: To determine the prevalence of anaemia and maternal and infant factors associated with Hb values in infants at 6 months of age in rural Bangladesh. Design: Infants (born to mothers supplemented with Fe-folic acid from midpregnancy) were visited at birth and 6 months of age. Mothers' anthropometric status, and infants' birth weight, gestational age at birth, weight and Hb concentration at 6 months were measured. Household socio-economic and demographic data, infant feeding practices and health status were collected using a pre-tested structured questionnaire. Setting: Rural Bangladesh. Subjects: Four hundred and two infants. Results: For the total cohort (n 402), the range of anaemia prevalence values was from 30·6% using a cut-off value of Hb<95 g/l to 71·9% using a value of Hb<110 g/l. Birth weight and month of birth were the only factors positively associated with infant Hb in a linear regression model (P=0·008 and 0·011, respectively). Conclusions: There was an unexpectedly high prevalence of anaemia in infants at 6 months of age, before the assumed period of vulnerability. Hb at this age tended to be higher in those with higher birth weight. We also found a season effect on Hb, as it tended to be higher as the study progressed. The high prevalence of anaemia at such an early age needs to be addressed to minimize the disease's long-term consequences. [ABSTRACT FROM AUTHOR]

Background. The effectiveness of commonly suggested public health interventions to control childhood iron-deficiency anemia has been low. Objective. To determine whether iron provided in Sprinkles daily or in a higher dose once weekly affected hemoglobin, serum ferritin levels, and serum transferrin receptor levels, and to determine whether there were differences in the effects of the two regimens. Methods. In this cluster-randomized, community-based trial conducted in rural areas of Bangladesh, 136 children aged 12 to 24 months with mild to moderate anemia (hemoglobin 70-109 g/L) were randomly allocated to receive Sprinkles daily (12.5 mg of elemental iron, n = 79) or once weekly (30 mg of elemental iron, n = 73) for 8 weeks. Hemoglobin, serum ferritin, and serum transferrin receptor were assessed at the start and end of the intervention. Results. In both groups, there were significant increases in hemoglobin and serum ferritin and a significant decrease in serum transferrin receptor (p <). There were no significant differences between the groups in the increases in hemoglobin (16.1 ± 13.2 g/L for the group receiving Sprinkles daily and 12.3 ± 13.3 g/L for the group receiving Sprinkles once weekly) and serum ferritin (10.6 and 5.7 µg/L, respectively). The decrease in serum transferrin receptor also did not significantly differ between the groups (median, -2.5 and -1. 8 mg/L, respectively). The prevalence rates of iron-deficiency anemia, depleted iron stores, and tissue iron deficiency decreased significantly within each group (p < .01), with no significant differences between the groups. Conclusions. Home fortification of complementary foods with Sprinkles given either daily or once weekly improved iron-deficiency anemia and iron status among young children. [ABSTRACT FROM AUTHOR]

Background: Anaemia and iron-deficiency anaemia in women are global problems that are prevalent throughout the reproductive cycle. Data are scarce on whether iron supplementation in pregnancy and puerperium has a sustained effect on haemoglobin concentration. Objective: To assess whether there is a dose effect of iron supplementation in pregnancy and puerperium on haemoglobin 6 weeks after delivery, and compare the effectiveness of daily and weekly dose regimens at 6 weeks postpartum. Design: 50 antenatal centres were assigned randomly to 1×60 mg iron daily or 2×60 mg once weekly. Data are reported for 146 women (daily, n =67; weekly, n =79): haemoglobin, serum ferritin (sFt) and serum transferrin receptors (sTfR) at baseline and at 6 weeks postpartum. Tablet intake was monitored using pill-bottles equipped with electronic counting devices. Results: There was a dose effect of iron supplementation on haemoglobin concentration at 6 weeks postpartum. Endpoint attained haemoglobin, sFt and sTfR did not differ between daily and weekly groups, although a larger increment of sFt was found in the daily group ( p =0.03). Conclusions: Effects of iron supplementation in pregnancy and puerperium were observed at 6 weeks after delivery. The size of the effect was dependent on the number of tablets, not on daily or weekly regimen. It is not known whether the effects of iron supplementation in pregnancy are sustained into the next pregnancy. [ABSTRACT FROM AUTHOR]

Background: According to our current understanding, iron absorption with weekly iron supplements is not higher than that with daily supplements (ie, there is no mucosal block). However, community-based trials have repeatedly shown that a weekly regimen is as effective as a daily one. Furthermore, when differences in absorption are found, they are commonly smaller than would be expected on the basis of differences in the amount of iron provided. The possibility of differential compliance between the regimens needs to be evaluated to explain these findings. Objective: Taking compliance into account, we compared the efficacy and trial effectiveness of weekly and daily iron supplementation during pregnancy. Design: In Bangladesh, 50 antenatal centers were randomly assigned to prescribe either 2 doses of 60 mg Fe once weekly or 1 dose of 60 mg Fe/d. Compliance was monitored by using a pill bottle equipped with an electronic counting device. Hemoglobin concentrations were measured at baseline and after 4, 8, and 12 wk of supplementation. Results: There was no differential effect per iron tablet between weekly and daily regimens. A 12-wk daily regimen (68% compliance) produced a small but significantly greater hemoglobin response than did the weekly regimen (104% compliance). The first 20 tablets consumed produced most of the effect; after 40 tablets, there was no further response. Conclusions: There was no evidence of a mucosal block in the daily regimen. Over 12 wk, 50% of the amount of iron in a daily regimen was sufficient for maximum hemoglobin effect. The weekly regimen provided a large part of this amount, explaining the limited difference in effect. It appears that the current international recommendation for iron supplementation in pregnancy is higher than necessary. [ABSTRACT FROM AUTHOR]