Effective community intervention to improve hemoglobin status in preschoolers receiving once-weekly iron supplementation

The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked, placebo-controlled field trial. Subjects were 289 preschoolers who were randomly divided into three groups. Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo. Group 1 additionally received anthelminthic treatment. Supplements were administered by the mothers, who were educated about iron deficiency beforehand. In the iron-supplemented groups prevalence of anemia decreased from 37.2% to 16.2% (P < 0.001). Hemoglobin increased by an average of 6.9 +/- 9.8 g/L in the two iron-supplemented groups (n = 191), which was greater (P < 0.001) than the increase of 1.9 +/- 8.0 g/L in the placebo group. None of the subjects had hookworm, and anthelminthic treatment did not have an additional effect. Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff.

Iron status of Zairean pregnant women with and without serological markers of hepatitis B virus infection

We assessed the iron status of 203 Zairean pregnant women: 38 with chronic hepatitis B virus (HBV) infection (HBsAg(+)), 94 with antibodies to the surface antigen (Anti-HBs(+)) and 71 without HBV markers (HBsAg(-)/Anti-HBs(-)). Participants, age range 15-42 years and parity 1-12, were recruited from Mama Yemo Hospital in summer 1983. Haemoglobin (Hb), serum iron, total iron binding capacity and transferrin saturation (TS) were determined by standard techniques and serum ferritin (FERR) by radioimmunoassay. To rule out inflammation and/or infection which increase FERR levels, C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP) were also measured. There was no significant difference in the mean levels of any of the haematologic measurements, FERR, CRP and AGP between the three HBV groups. Women who took iron supplements had slightly higher mean levels of Hb but not serum FERR or TS than those who did not. Women with inflammation and identical HBV markers had higher mean FERR levels than those without inflammation. Neither the prevalence of anaemia, which varied between 32 and 35%, nor that of iron deficiency, which varied between 52 and 59%, differed significantly between the three groups of women. We conclude that in pregnant women, chronic asymptomatic HBV infection is not associated with a lower prevalence of iron deficiency and/or anaemia.

Hemostatic changes in women using a monthly injectable contraceptive for one year

The effect of consecutively injecting a one-a-month contraceptive (norethisterone enantate 50 mg with estradiol valerate 5 mg) for one year on haematological parameters was evaluated in 42 Chinese women. The healthy volunteers were randomly allocated to either the treatment group (22) or a control group (20). Blood samples were collected in the follicular and luteal phases of a pretreatment cycle, on days 28 +/- 3 after the 1st, 3rd, 6th, 12th injections and in the luteal phase of the post-treatment cycle. The results showed that in both groups, prothrombin time and fibrinogen fluctuated significantly, and leucocyte count was not significantly changed during the whole course. Factor VIII-related antigen and antithrombin III (AT-III) antigen showed minor changes, although in the 3rd treatment cycle, the differences between the two groups in both parameters reached statistical significance. A progressive and significant decrease in Factor X and AT-III functional activity occurred with the monthly injectable treatment, decreasing by about 14% and 20%, respectively, after 12 months of treatment. Haemoglobin levels were increased in the treatment group after the 3rd injection and remained at the higher level during the study period. It is doubtful whether these changes are likely to be of clinical relevance.

Effect of Norplant contraceptive use on hemoglobin, packed cell volume and menstrual bleeding patterns

A study was conducted to evaluate the effect of NORPLANT use on hemoglobin levels (HB), packed cell volume (PCV) and menstrual bleeding patterns. NORPLANT insertions were performed on 50 healthy volunteers in Ilorin, Nigeria, between January-March 1986. Whole blood samples were collected at admission, 6-month and 12-month follow-up visits, and each acceptor was asked to keep a daily bleeding calendar. Mean age of the acceptors was 32.8 years with a mean parity of 5.3 live births. Almost 50% of the acceptors indicated that they did not want any more children. After 12 month's follow-up, there were a total of three discontinuations, two for excessive menstrual bleeding and one due to husband's objection. Mean HB and PCV values remained relatively unchanged from admission to 12 months. Nearly 50% of the women experienced at least one episode of 8 or more days of continuous bleeding during the first six months of use, and about 20% reported amenorrhea of 90 or more days. Despite the incidence of menstrual bleeding irregularities, acceptability of the NORPLANT method was high as indicated by a 1-year continuation rate of 93.7 per 100 users. Clinically more important was the finding that despite a high proportion of women reporting menstrual pattern changes, HB and PCV levels remained unchanged.

The role of the levonorgestrel intrauterine device in the prevention and treatment of iron deficiency anemia during fertility regulation

Hematocrit and blood ferritin were assayed in 43 women using a levonorgestrel intrauterine device (LevoNg-IUD), 49 using the Copper T-380 Ag (T-Cu 380 Ag), 27 using the Lippes loop and 30 non-IUD users as controls. The mean duration of use was 41 months for the three IUD groups. Women not using IUDs and with similar age, parity, years of schooling and family income as users had a normal mean hematocrit and ferritin, but 30% had low hematocrit (below 38%) and 43% had low ferritin (below 11 ng/ml). After prolonged use of the IUDs, 26% of users of Lippes loop, 22% of users of T-Cu 380 Ag and only 2% of users of LevoNg-IUD had subnormal hematocrit; 70%, 55% and 14%, respectively, had low ferritin. Thus, in a population with high incidence of anemia, the use of LevoNg-IUD appears to reduce the proportion of women with clinical anemia and with depletion of their iron store.

Menstrual blood loss, haemoglobin and ferritin concentration of Beijing women wearing steel ring, VCu 200, and TCu 220c IUDs

Menstrual blood loss (MBL), serum ferritin and whole blood cyanmethemoglobin were measured at pre- and 1, 3, 6, 12, 18 and 24th postinsertion cycles in 60 women wearing the Steel Ring, the Copper V (VCu 200) or the Copper T (TCu 220c). The MBL, incidence of menorrhagia and iron deficiency anemia were lower among users of the Steel Ring than among users of the Copper V and T. Anemia occurred later and the duration of menstruation was shorter with the Steel Ring than with the Copper T. There were no statistically significant differences between the Copper V and T.

A multicenter study of levonorgestrel-estradiol contraceptive vaginal rings. II-Subjective and objective measures of effects. An international comparative trial

Comparative clinical trials of 2 sizes of contraceptive vaginal rings and of an oral contraceptive were undertaken at 8 investigational sites (9 clinics). More than 500 women enrolled on each of the 3 study regimens. Side effects of the rings and of Nordette, the oral contraceptive, were evaluated by noting spontaneous complaints, by recording medications taken and by physical examination. Inquiries about changes in the frequency of specific conditions were made at the end of the subjects participation in the first year of the study. The incidence of spontaneous complaints was similar among users of the 2 different-sized rings and of the pill.