Effective Of Large Dose Vitamin A And Weekly Iron Supplementation On Improving Iron Status Of Preschoolers

[Objective] Vitamin A deficiency and iron deficiency, known as 'hidden hunger',are the most common micronutrient deficient diseases around the world. And they are among the most important diseases to be eliminated by the WHO and UNICEF. Therefore, it's important to seek an effective method to improve the vitamin A and iron status of preschoolers. Micronutrient supplementation is a widely used approach to improve the VA and iron status. The most common methods are large dose VA supplementation(oral 200000IU VA capsule every 4-6 months ) and daily iron supplementation(60mg iron daily). It was verified that weekly iron supplementation has the same efficacy with daily iron supplementation, while it's effectiveness is determined by the local condition. Since vitamin A deficiency influenced the transportation of iron to tissues and depressed erythropoiesis, the project was designed to find an effective approach toimprove VA and iron status of preschoolers at the same time. SF and sTfR are also detected in the trial.[Methods] During Nov.2000 to May.2001, A cross sectional study and a clinical trial were conducted in suburb Chongqing. Hb and serum VA were detected in all the children of 3 kindergartons. After the cross sectional study, 183 children who were iron deficient anemia and/or vitamin A deficiency were randomly divided into three groups, and were arranged to receive 60mg iron/week for 20 weeks, 10mg vitamin B1/week (placebo)for 20 weeks or 50000IU vitamin A capsule/week for 4 weeks respectively.Hb, serum VA, SF and sTfR were detected in the 5th week after supplementation. Hb was detected in the 20th week after supplementation for the 3rd time.[Results] 1. The prevalence of VAD in the study area was 38.8%, and the prevalence of IDA was 26.2%. 2.In the multiple stepwise reggression analysis, the influence of parents' education, occupation, income, Engel index, breast milk, weaning time, children's dietary habits to the serum VA status or the hemoglobin concentration was analyzed, children's dietary habits showed a positive effect to serum VA status (standard parameter estimate is 0.13), while the effect of children's dietary habits to hemoglobin concentration is not significant. 3.There is a positive correlation between hemoglobin concentration and serum VA concentration (correlation coefficient is 0.16). 4. Oral large dose of 200000IU VA capsule and weekly supplementation of 60mg iron significantly improved the hemoglobin concentration of 8.9g/L and 10.4g/L, respectively. 5. Serum ferritin were raised in the VAD children, and it showed a negative correlation with serum VA concentration (correlation coefficient is -0.17). Serum ferritin is decreased while the serum VA status was improved. 6.Serum transferrin receptor levels were normal in the VAD children, and it is increased while the serum VA status was improved.[Conclusions] 1.VAD and IDA are public health problems in suburb Chongqing.2. Large dose vitamin A supplementation has the same effect on the increase of Hb concentration with the weekly supplementation of 60mg iron. 3.Since vitamin A deficiency influenced the transportation of iron to tissues and depressed erythropoiesis, for children who has VAD and anaemia at the same time, their serum ferritin levels are increased and the sTfR levels are normal...