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A Novel School-based Intermittent Delivery System of Iron Supplements for Highly Marginalized Tarahumara Indigenous Women of Reproductive Age of Northern Mexico.

Ecology of food and nutrition
January 1, 2020
Vittoria Crispino et al. (2 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to evaluate a novel delivery scheme involving walking times as a factor in adherence to iron supplementation in highly isolated indigenous communities.

Results Summary

Walking times were found to influence adherence, with higher adherence linked to shorter walking times. The intervention significantly reduced anemia by 48.2% and iron-deficient anemia by 67.7% in the supplementation group.

Population

Indigenous Tarahumara communities in Mexico, specifically children and women with anemia.

Effective Dosage

Not specified

Duration

16 weeks

Interactions

None mentioned

Extracted Claims (2)
InterventionDirectionEndpointPopulationDosageImpactClaim #
iron supplement
decrease
anemia
women in the intervention group
48.2%
significantly decreased the proportion of
#1
iron supplement
decrease
iron-deficient anemic women
women in the supplementation group
67.7%
significantly reduced the number of
#2
Abstract

To develop a novel delivery scheme to bridge the Mexican health system with highly isolated indigenous communities by involving naturally occurring social links: households and boarding schools. This was a school-based placebo-controlled trial with a follow-up period of 16 weeks. Children whose mothers fulfilled the inclusion criteria for anemia acted as iron supplement carriers between schools and homes. Adherence was measured based on teachers' and mothers' records. An effectiveness sub-analysis assessed changes in biochemical profiles according to random allocation to either supplementation or placebo groups. There was an overall high adherence in both groups. Analyses revealed that schooling years, literacy, and walking times played a role in high adherence. Logistic regression showed that women had higher adherence odds on the basis of household size, walking times, and previous inclusion in supplement distributions. Adherence significantly decreased the proportion of anemia by 48.2% in the intervention group. The difference at baseline and endpoint significantly reduced the number of iron-deficient anemic women by 67.7% in the supplementation group. This delivery method is a valid alternative to the conventional efforts used to reach Tarahumara indigenous communities, and could also have the potential to be piloted to tackle other health issues hindering these marginalized communities.

Medical Subject Headings (MeSH)
AdultAnemia, Iron-DeficiencyChildDelivery of Health CareDietary SupplementsFemaleHealth Services AccessibilityHumansIndigenous PeoplesIron, DietaryMexicoMothersSchoolsYoung AdultAssessment of Medication Adherence
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality78/10
Citation Metrics
Total Citations2
Citations/Year0.4
Relative Citation Ratio0.21
NIH Percentile10.5%
Research Impact Scores
APT Score0.25
Weight Score2.04
Normalized Score0.70
Related Supplements
A Novel School-based Intermittent Delivery System of Iron Su... | Panacea Index