Effect on school attendance and performance of iron and multiple micronutrients as adjunct to drug treatment of Schistosoma-infected anemic schoolchildren.
Study Goal
The researchers aimed to assess the effect of iron and multiple micronutrients, combined with praziquantel, on school attendance and achievement in children with S. haematobium infection and anemia.
Results Summary
Combined praziquantel and iron treatment improved school attendance, particularly in younger children (7-9 years old), but did not significantly affect school grades. Iron treatment alone showed a borderline significant effect on grades.
Population
7- to 12-year-old anemic children with S. haematobium infection in Mali (n = 406).
Effective Dosage
Not specified in the abstract.
Duration
3 months.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
praziquantel alone | increase | school attendance and performance | 7- to 12-year-old anemic children with documented S. haematobium infection | - | improved | #1 |
praziquantel + iron | increase | school attendance and performance | 7- to 12-year-old anemic children with documented S. haematobium infection | - | improved | #2 |
praziquantel + multiple micronutrients | increase | school attendance and performance | 7- to 12-year-old anemic children with documented S. haematobium infection | - | improved | #3 |
praziquantel + multiple micronutrients + iron | increase | school attendance and performance | 7- to 12-year-old anemic children with documented S. haematobium infection | - | improved | #4 |
iron treatment | increase | attendance | 7- to 9-year-old children | - | significant main effect | #5 |
iron treatment | increase | school grades | 7- to 9-year-old children | - | borderline significance | #6 |
combined praziquantel and iron treatment | increase | school attendance and performance | children | - | improved | #7 |
BACKGROUND: Relationships among Schistosoma haematobium, anemia, and iron deficiency have been documented, and all have been found to be associated with a decline in school attendance and lower performance. OBJECTIVE: To assess the effect of single or combined iron and multiple micronutrients and/or praziquantel on school attendance and achievement in randomly selected 7- to 12-year-old anemic children with documented S. haematobium infection (n = 406) in Mali over a 3-month period. METHODS: Schistosomiasis infection was diagnosed by the presence of schistosome eggs in the urine. Venous blood samples (5 mL) were drawn from an antecubital vein for hemoglobin assessment. Children were randomly assigned to one of four treatment groups: praziquantel alone, praziquantel + iron, praziquantel + multiple micronutrients, and praziquantel + multiple micronutrients + iron. School attendance was defined by the number of days the child was absent from class. Achievement was defined by the child's overall school grades. RESULTS: Changes within treatment groups from baseline to the end of study were found for attendance (p < .001) but not for achievement (p > .05). Significant supplement treatments by age group interactions were found in 7- to 9-year-old children for attendance. Further exploration of treatment effects in this age group showed that only iron treatment's main effect was significant on attendance (p = .049) and was of borderline significance on school grades (p = .08). CONCLUSIONS: Combined praziquantel and iron treatment improved children's school attendance and performance better than praziquantel alone, particularly among younger children.