Hematologic effect of vitamin A supplementation in anemic Pakistani children. Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months Effect of maternal and neonatal vitamin A supplementation and other postnatal factors on anemia in Zimbabwean infants: a prospective, randomized study. Effect of vitamin A and Zn supplementation on indices of vitamin A status, haemoglobin level and defecation of children with persistent diarrhea Effectiveness of weekly vitamin A (10 000 IU) and iron (60 mg) supplementation for adolescent boys and girls through schools in rural and urban East Java, Indonesia Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions Improvement in iron deficiency anemia through therapy with ferric ammonium citrate and vitamin C and the effects of aerobic exercise. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. Impact of Multi-Micronutrient Fortified Rice on Hemoglobin, Iron and Vitamin A Status of Cambodian Schoolchildren: a Double-Blind Cluster-Randomized Controlled Trial Subclinical inflammation influences the association between vitamin A- and iron status among schoolchildren in Ghana Identification of an appropriate strategy to control anemia in adolescent girls of poor communities.
To assess the prevalence of vitamin A deficiency in anemic Pakistani children and investigate the hematologic response to vitamin A supplementation , 4 - 8 year old primary school children from the slum areas of Karachi were surveyed for anemia . Of 101 anemic children selected , 16 % had low level of vitamin A ( < 20 micrograms/dl ) and an additional 2 % had deficient level ( < 10 micrograms/dl ) . Serum Retinol level showed positive associated with serum iron , ferritin , hemoglobin , hematocrit and Mean cell hemoglobin concentration . A non-r and omized control trial was then carried out . Oral vitamin A capsules were given to 42 children and 53 children served as controls . After 6 weeks , there were significant differences between the two groups for Retinol , Retinol-Binding-Protein and Hematocrit . However , no significant difference could be found for Hemoglobin , RBC count , Mean Corpuscular Volume , Mean Corpuscular Hemoglobin , Mean Corpuscular Hemoglobin Concentration , Serum iron , ferritin or transferrin . A single vitamin A supplement improved the hematocrit in 6 weeks . Long-term studies are needed to find if the WHO recommended periodic massive doses of vitamin A besides improving the morbidity and mortality will also improve the overall picture of anemia in children Background The benefits of zinc or multiple micronutrient supplementations in African children are uncertain . African children may differ from other population s of children in developing countries because of differences in the prevalence of zinc deficiency , low birth weight and preterm delivery , recurrent or chronic infections such as HIV , or the quality of complementary diets and genetic polymorphisms affecting iron metabolism . The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6 - 24 months . Methods R and omized , controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6 - 24 months . Children in three cohorts - 32 HIV-infected children , 154 HIV-uninfected children born to HIV-infected mothers , and 187 uninfected children born to HIV-uninfected mothers - were separately r and omly assigned to receive daily vitamin A ( VA ) [ n = 124 ] , vitamin A plus zinc ( VAZ ) [ n = 123 ] , or multiple micronutrients that included vitamin A and zinc ( MM ) [ n = 126 ] . Results Among all children there were no significant differences between intervention arms in length-for-age Z scores ( LAZ ) changes over 18 months . Among stunted children ( LAZ below -2 ) [ n = 62 ] , those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA ( P = 0.029 when comparing effects of treatment over time ) . In the 154 HIV-uninfected children , MM ameliorated the effect of repeated diarrhea on growth . Among those experiencing more than six episodes , those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively ( P = 0.06 for treatment by time interaction ) . After 12 months , there was 24 % reduction in proportion of children with anemia ( hemoglobin below 11 g/dL ) in MM arm ( P = 0.001 ) , 11 % in VAZ ( P = 0.131 ) and 18 % in VA ( P = 0.019 ) . Although the within arm changes were significant ; the between-group differences were not significant . Conclusions Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting , compared to vitamin A alone or to vitamin A plus zinc . Effects on anemia require further study .Trial registration This study is registered with Clinical Trials.gov , number .NCT00156832 BACKGROUND Anemia is prevalent in infants in developing countries . Its etiology is multifactorial and includes vitamin A deficiency . OBJECTIVE Our primary aim was to measure the effect of maternal or neonatal vitamin A supplementation ( or both ) on hemoglobin and anemia in Zimbabwean infants . Our secondary aim was to identify the underlying causes of postnatal anemia . DESIGN A r and omized , placebo-controlled trial was conducted in 14 110 mothers and their infants ; 2854 infants were r and omly selected for the anemia sub study , of whom 1592 were successfully observed for 8 - 14 mo and formed the study sample . Infants were r and omly assigned within 96 h of delivery to 1 of 4 treatment groups : mothers and infants received vitamin A ; mothers received vitamin A and infants received placebo ; mothers received placebo and infants received vitamin A ; and mothers and infants received placebo . The vitamin A doses were 400,000 and 50,000 IU in the mothers and infants , respectively . RESULTS Vitamin A supplementation had no effect on hemoglobin or anemia ( hemoglobin < 105 g/L ) in unadjusted or adjusted analyses . Infant HIV infection independently increased anemia risk > 6-fold . Additional predictors of anemia  in HIV-negative and -positive infants were male sex and lower total body iron at birth . In addition , in HIV-positive infants , the risk of anemia increased with early infection , low maternal CD4 + lymphocyte count at recruitment , and frequent morbidity . Six-month plasma ferritin concentrations < 12 microg/L were a risk factor in HIV-negative but not in HIV-positive infants . Maternal HIV infection alone did not cause anemia . CONCLUSION Prevention of infantile anemia should include efforts to increase the birth endowment of iron and prevent HIV infection To investigate the effect of vitamin A and Zn supplementation on vitamin A status , haemoglobin level and defecation of children with persistent diarrhea , a total of 160 paediatric patients were r and omly assigned to one of four intervention groups : daily supplementation of 1,500 IU VA for 14 days ; daily Zn supplementation for 14 days ; daily supplementation with both VA and Zn for 14 days ; no supplementation .  One hundred twenty-seven children with persistent diarrhea finished intervention ( 33 were lost to follow-up ) . Among the 127 children , 41 ( 32.28 % ) had anaemia , 104 ( 81.89 % ) had a VA deficiency and 38 ( 29.92 % ) had an iron insufficiency . Supplementation with VA or VA + Zn enhanced the serum VA levels and ameliorated anaemia . Supplementation with Zn and VA + Zn for 5 days significantly improved defecation , where the VA + Zn treatment result ed in superior outcomes . After 14 days of intervention , the total effectiveness rates were 93.94 % , 96.77 % and 96.67 % in the three groups , significantly greater than that of the non-supplementation group ( 72.73 % ) . These results indicate that single VA or concurrent VA + Zn supplementation can improve vitamin A status , haemoglobin level and defecation .  However , concurrent VA + Zn supplementation is the optimal option and can shorten the duration of persistent diarrhea and markedly improve nutritional status . ( www . clinical trials.gov registration number : ChiCTR-IOR-14005498 Objective : High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions . This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status . Design : School-based , grade -r and omized , intervention . Subjects and setting : In all , 1757 girls and 1859 boys , aged 12–15 y , in 24 Junior High Schools . Interventions : Weekly supplementation for 14 weeks with 60 mg iron and 250 μg folate ( Fe group ; n=978 ) , 10 000 IU vitamin A ( VA group ; n=970 ) or both ( VAFe group ; n=1042 ) to subjects in 15 schools , compared to subjects in nine other schools not receiving supplements  ( control ; n=626 ) . Results : The baseline anaemia prevalence ( Hb < 120 g/l ) in girls was 20 % ( prepubertal ) and 26 % ( pubertal ) , and in boys 24 % ( pre-pubertal ) and 11 % ( pubertal ) . Serum retinol concentrations were low ( < 1.05 μmol/l ) in 41 % of boys and 45 % of girls . The interventions did not increase haemoglobin concentrations . Serum retinol concentration of boys , but not girls , in the VA group increased ( 0.33 vs 0.07 μmol/l in controls ; P<0.01 ) . The risk factors for low serum retinol concentration were lower baseline serum retinol concentration ( OR 0.02–0.03 ) with , for girls , nightblindness at baseline ( OR 5.88 ) , and for boys , not receiving vitamin A ( OR control : 1.00 ; VA : 0.37 ; Fe : 0.77 ; VAFe : 0.34 ) and maternal illiteracy ( OR mother never attended school 1.00 , mother received any formal education 0.17–0.33 ) . Conclusions : Supplementation with vitamin A increased serum retinol concentration of boys . Iron supplementation did not change Hb . This appeared to be due to poor compliance , and partly related to side effects . Sponsorship : This study was funded by USAID through the OMNI Project Iron deficiency anaemia ( IDA ) is the most common nutritional deficiency in the world including developed and developing countries . Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia , anaemia and IDA are still major public health problems in these communities particularly among children . A r and omized , double-blind , placebo-controlled trial was conducted on 250 Orang Asli ( aboriginal ) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation ( 200,000 IU ) on iron status indices , anaemia and IDA status . The effect of the supplement was assessed after 3 months of receiving the supplements ; after a complete 3-day deworming course of 400 mg/day of albendazole tablets . The prevalence of anaemia was found to be high : 48.5 % ( 95 % CI = 42.3 , 54.8 ) . Moreover , 34 % ( 95 % CI = 28.3 , 40.2 ) of the children had IDA , which accounted for 70.1 % of the anaemic cases . The findings showed that the reduction in serum ferritin level and the increments in haemoglobin , serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group ( p < 0.01 ) . Moreover , a significant reduction in the prevalence of IDA by almost 22 % than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3 % reduction among children in the placebo group . In conclusion , vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children . Hence , providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities Background / Objectives : Iron deficiency anemia is a major public health problem in developing countries and may affect school performance and physical work capacity in nonpregnant adolescents , and may increase the risk of anemia during subsequent teenage pregnancies . We assessed the effect of weekly iron ( 120 mg elemental iron ) and vitamin A ( 25 000 IU ) supplementation on hemoglobin , iron status and malaria and nonmalaria morbidity in adolescent schoolgirls . Subjects/ Methods : A total of 279 schoolgirls aged 12–18 years from public primary schools in Kisumu , western Kenya . Double-blind r and omized placebo-controlled trial using a factorial design . Results : Five months of iron supplementation was associated with a 0.52 g dl−1 ( 0.21 , 0.82 ) greater increase in hemoglobin relative to iron placebo . The effect was only observed in girls with iron deficiency on enrollment ( 1.34 g dl−1 ( 0.79 , 1.88 ) ) , but not in iron-replete girls ( −0.20 g dl−1 ( −0.59 , 0.18 ) ) . Similar differences in treatment effect were seen between menstruating and nonmenstruating girls . The effect of iron was independent of vitamin A. The baseline prevalence of vitamin A deficiency was low ( 6.7 % ) and no sustained increase in hemoglobin was seen with weekly vitamin A ( −0.07 g dl−1 ( −0.38 , 0.25 ) ) . Incidence of malaria parasitemia was higher in the iron than iron-placebo groups ( Rate ratio 1.33 ( 0.94 , 1.88 ) ) . Conclusions : Weekly iron supplementation results in substantial increases in hemoglobin concentration in adolescent schoolgirls in western Kenya , which may outweigh possible risks caused by malaria , but only in iron-deficient or menstruating girls and not in iron-replete and nonmenstruating girls BACKGROUND Vitamin A deficiency impairs iron metabolism ; vitamin A supplementation of vitamin A-deficient population s may reduce anemia . The mechanism of these effects is unclear . In vitro and in animal models , vitamin A treatment increases the production of erythropoietin ( EPO ) , a stimulant of erythropoiesis . OBJECTIVE We measured the effect of vitamin A supplementation on hemoglobin , iron status , and circulating EPO concentrations in children with poor iron and vitamin A status . DESIGN In a double-blind , r and omized trial , Moroccan schoolchildren ( n = 81 ) were given either vitamin A ( 200,000 IU ) or placebo at baseline and at 5 mo . At baseline , 5 mo , and 10 mo , hemoglobin , indicators of iron and vitamin A status , and EPO were measured . RESULTS At baseline , 54 % of children were anemic ; 77 % had low vitamin A status . In the vitamin A group at 10 mo , serum retinol improved significantly compared with the control group ( P < 0.02 ) . Vitamin A treatment increased mean hemoglobin by 7 g/L ( P < 0.02 ) and reduced the prevalence of anemia from 54 % to 38 % ( P < 0.01 ) . Vitamin A treatment increased mean corpuscular volume ( P < 0.001 ) and decreased serum transferrin receptor ( P < 0.001 ) , indicating improved iron-deficient erythropoiesis .  Vitamin A decreased serum ferritin ( P < 0.02 ) , suggesting mobilization of hepatic iron stores . Calculated from the ratio of transferrin receptor to serum ferritin , overall body iron stores remained unchanged . In the vitamin A group at 10 mo , we observed an increase in EPO ( P < 0.05 ) and a decrease in the slope of the regression line of log10(EPO ) on hemoglobin ( P < 0.01 ) . CONCLUSION In children deficient in vitamin A and iron , vitamin A supplementation mobilizes iron from existing stores to support increased erythropoiesis , an effect likely mediated by increases in circulating EPO We conducted a r and omized controlled trial of the effects of dietary supplements on anemia , weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania . The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children . The supplements were vitamin A alone , iron and vitamin A , iron alone or placebo , administered in a double-blinded design for 3 mo . All supplements were provided with local corn meals .  Hemoglobin concentration , body weight and height were measured at baseline and at follow-up after supplementation . Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [ P < 0.0001 , 95 % confidence interval ( CI ) 6.19 - 13.57 ) , the mean body weight by 0.6 kg compared with 0.2 kg for placebo ( P < 0.0001 , 95 % CI 0.19 - 0.65 ) and the mean height by 0.4 cm compared with 0.1 cm for placebo ( P = 0.0009 , 95 % CI 0.08 - 0.42 ) . However , the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo ( 18.5 g/L , P < 0.0001 , 95 % CI 14.81 - 22.23 ; 0.7 kg , P < 0 . 0001 , 95 % CI 0.43 - 0.88 and 0.4 cm , P < 0.0001 , 95 % CI 0.22 - 0.56 for hemoglobin , weight and height , respectively ) . It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia , as well as in improving children 's growth , in developing countries Nutritional anaemia , thought to be caused by iron deficiency , affects 50 - 70 % of pregnant women in the developing world . The influence of vitamin A and iron supplementation was studied in anaemic pregnant women in West Java , in a r and omised , double-masked , placebo-controlled field trial . 251 women aged 17 - 35 years , parity 0 - 4 , gestation 16 - 24 weeks , and haemoglobin between 80 and 109 g/L were r and omly allocated to four groups : vitamin A ( 2.4 mg retinol ) and placebo iron tablets ; iron ( 60 mg elemental iron ) and placebo vitamin A ; vitamin A and iron ; or both placebos , all daily for 8 weeks . Maximum haemoglobin was achieved with both vitamin A and iron supplementation ( 12.78 g/L , 95 % Cl 10.86 to 14.70 ) , with one-third of the response attributable to vitamin A ( 3.68 g/L , 2.03 to 5.33 ) and two-thirds to iron ( 7.71 g/L , 5.97 to 9.45 ) . After supplementation , the proportion of women who became non-anaemic was 35 % in the vitamin-A-supplemented group , 68 % in the iron-supplemented group , 97 % in the group supplemented with both , and 16 % in the placebo group . Improvement in vitamin A status may contribute to the control of anaemic pregnant women BACKGROUND Iron deficiency is the most common micronutrient deficiency and affects > 2 billion persons worldwide , leading to anemia in > 40 % of women of reproductive age in the developing world . OBJECTIVE The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant . DESIGN Participants with a hemoglobin concentration of 80 - 120 g/L were entered into a r and omized , double-blind , placebo-controlled trial and received supplements of placebo , vitamin A , iron + folic acid , or iron + folic acid + vitamin A weekly for 12 wk . The supplements contained 2.42 mg vitamin A ( retinol ) as retinyl palmitate , 120 mg elemental Fe as ferrous sulfate , and 3.5 mg folic acid . RESULTS Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone . There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid , but the additional effect disappeared after adjustment for baseline hemoglobin , serum vitamin A , and ferritin and the number of supplements taken . Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin . Compared with the placebo , iron + folic acid + vitamin A reduced anemia by 92 % , iron deficiency by 90 % , and vitamin A deficiency by 76 % . CONCLUSION There may be significant health benefits from a program that enhances the nutritional status of iron , folate , and vitamin A in poor urban young women before they become pregnant Objective : Anemia is a major public health problem caused by multiple factors . Vitamin A ( VA ) depletion can affect hemoglobin concentration ( Hb ) . This study investigated the improvement in Hb and VA status in preschool Indonesian children following supplementation with 210 μmol VA and deworming with 400 mg albendazole . Subjects and design : Indonesian children ( n=131 ) infected with Ascaris lumbricoides and /or Trichuris trichiura were enrolled . The children were grouped by length of time since receiving 210 μmol VA through the local health system . Group 1 ( VA administered ≥4 month before baseline ) included 51 children with Ascaris and 29 children with Trichuris . Group 2 had received VA ≤1 month of baseline from the local health post and included 51 children . Intervention and methods : Immediately following baseline Hb and VA status assessment ( modified relative dose response ( MRDR ) test ) , Group 1 children were given 210 μmol VA and 400 mg albendazole . Group 2 were r and omized to be dewormed either 1 week before , at the same time or 1 week after baseline MRDR and Hb measures . Follow-up assessment was 3–4 weeks after baseline . Results : VA status in Group 1 significantly improved in children with either Ascaris ( P<0.0001 ) or Trichuris ( P=0.028 ) . Although the prevalence of anemia declined , the improvement in Hb was not significant ( P=0.08 ) . In Group 2 , improvement in VA status from the VA delivered through the public health system was maintained for more than 1 month . Hb improved ( P=0.0037 ) and this improvement appeared to be associated with the length of time between deworming and follow-up assessment s. Conclusion : Public health supplementation programs to improve VA status may also increase Hb concentrations and decrease anemia prevalence , especially when linked to deworming . Sponsorship : These studies were supported by the Thrasher Research Fund , SmithKline Beecham and Hatch-Wisconsin Agricultural Experiment Station number WIS04533 In 781 female college students , there were 41 cases of iron deficiency anemia , 209 of latent iron deficiency , 3 of other anemias , and 528 normal cases . Fifty-four volunteers recruited from the iron deficiency anemia and severe latent iron deficiency groups were r and omly divided into 4 study groups . Groups I and III received 500 mg of vitamin C daily , and groups II and IV received ferric ammonium citrate ( FeAC ; equivalent to 6 mg iron ) in addition to vitamin C for 9 weeks . Groups I and II were loaded by aerobic exercise at 50 % VO2 max . Significant differences between groups were noted in serum ferritin ( SF ) in III/IV , hematocrit ( Ht ) in II/III and III/IV , and reticulocytes ( RET ) in I/II , I/IV , and III/IV . Hemoglobin ( Hb ) and other iron-related blood indices tended to normalize in groups II and IV when compared with the pre-values . VO2 max was elevated in groups I and II regardless of iron treatment , but was augmented more in group II than group Ninety-nine anemic children aged 1 - 8 y were divided into four groups . Each group was supplemented for 2 mo with vitamin A , iron , vitamin A plus Fe , or a placebo .  Clinical , hematological , and Fe biochemical evaluations were performed at the beginning and end of the study . Vitamin A supplementation produced significant elevations in the serum levels of retinol , blood hemoglobin , hematocrit , erythrocytes , serum Fe , and percent transferrin saturation ( % TS ) and had no effect on total Fe binding capacity ( TIBC ) or serum ferritin . Fe supplementation did not affect serum retinol . However , it improved hematological and Fe nutrition indicators , including TIBC and serum ferritin . The simultaneous administration of vitamin A and Fe result ed in a better response of serum Fe and % TS than when the supplement consisted only of vitamin A or Fe alone . Vitamin A benefits hematological condition and Fe metabolism In Cambodia , micronutrient deficiencies remain a critical public health problem . Our objective was to evaluate the impact of multi-micronutrient fortified rice ( MMFR ) formulations , distributed through a World Food Program school-meals program ( WFP-SMP ) , on the hemoglobin concentrations and iron and vitamin A ( VA ) status of Cambodian schoolchildren . The FORISCA-UltraRice+NutriRice study was a double-blind , cluster-r and omized , placebo-controlled trial . Sixteen schools participating in WFP-SMP were r and omly assigned to receive extrusion-fortified rice ( UltraRice Original , UltraRice New ( URN ) , or NutriRice ) or unfortified rice ( placebo ) six days a week for six months . Four additional schools not participating in WFP-SMP were r and omly selected as controls . A total of 2440 schoolchildren ( 6–16 years old ) participated in the biochemical study . Hemoglobin , iron status , estimated using inflammation-adjusted ferritin and transferrin receptors concentrations , and VA status , assessed using inflammation-adjusted retinol-binding protein concentration , were measured at the baseline , as well as at three and six months . Baseline prevalence of anemia , depleted iron stores , tissue iron deficiency , marginal VA status and VA deficiency were 15.6 % , 1.4 % , 51.0 % , 7.9 % , and 0.7 % , respectively . The strongest risk factors for anemia were hemoglobinopathy , VA deficiency , and depleted iron stores ( all p < 0.01 ) . After six months , children receiving NutriRice and URN had 4 and 5 times less risk of low VA status , respectively , in comparison to the placebo group . Hemoglobin significantly increased ( + 0.8 g/L ) after three months for the URN group in comparison to the placebo group ; however , this difference was no longer significant after six months , except for children without inflammation . MMFR containing VA effectively improved the VA status of schoolchildren . The impact on hemoglobin and iron status was limited , partly by sub- clinical inflammation . MMFR combined with non-nutritional approaches addressing anemia and inflammation should be further investigated Background and objective In re source -poor setting s , micronutrient deficiencies such as vitamin A deficiency may co-exist with iron-deficiency . In this study we assessed the iron and vitamin A status of schoolchildren and the association between vitamin A and iron status . Methods A cross-sectional design using the baseline data of a dietary intervention trial conducted among r and omly selected 5–12 years old schoolchildren ( n = 224 ) from 2 rural schools in northern Ghana .  Hemoglobin ( Hb ) , serum ferritin ( SF ) and serum transferrin receptor ( sTfR ) concentrations were used as measures of iron status . Retinol binding protein ( RBP ) was used as a measure of vitamin A status . Sub clinical inflammation ( SCI ) was measured using C-reactive protein ( CRP ) and α1-acid glycoprotein ( AGP ) concentrations . We examined the cross-sectional association between vitamin A and iron status biomarkers with multiple linear regressions . Results The proportions of schoolchildren with anemia ( WHO criteria ) , iron-deficiency ( ID , SF < 15μg/l and /or sTfR > 8.5mg/l ) and  iron-deficiency anemia  ( IDA , concurrent anemia and ID ) were 63.8 % , 68.3 % and 46.4 % respectively . Low or marginal vitamin A status ( 0.70 μmol/l ≤ RBP < 1.05μmol/l ) was present in 48.2 % while 37.5 % of the schoolchildren had vitamin A deficiency ( VAD , RBP < 0.70 μmol/l ) . The prevalence of SCI as well as concurrent VAD and ID were 48.7 % and 25 % respectively . RBP was associated with Hb ( β = 7.2 , P = 0.05 ) but not SF ( β = 20.7 , P = 0.33 ) and sTfR concentration ( β = 12.0 , P = 0.63 ) . In the presence of SCI , RBP was not associated with hemoglobin status but a significant positive association was observed among children without SCI . Conclusions The study shows that RBP is significantly associated with Hb concentration but not with SF and sTfR. The observed relationship between RBP and Hb is only significant in the absence of SCI OBJECTIVES To obtain baseline data on hemoglobin ( Hb ) levels of adolescent girls belonging to the low-socio-economic groups ; investigate the comparative efficacy of once ' weekly ' and ' daily ' administration of iron-folate tablets with respect to impact on the Hb levels ; and find out the effect of added ascorbic acid supplementation on the efficacy of iron-folate administration with respect to increment in Hb levels . DESIGN R and omized experimental . SETTING Adolescent girls of poor communities in urban areas of Delhi and rural parts of Bharatpur ( Rajasthan ) . METHODS The baseline investigations included measurements of height , weight , and Hb levels . The Hb levels of the participating subjects were measured again after 3 months and 6 months of supplementation . RESULTS 61.9 % of the subjects in the urban and 85.4 % in the rural area were anemic . The response of Hb levels to daily iron/folate supplementation was better in comparison to once-weekly supplementation . The increment in Hb levels of subjects due to addition of vitamin C to iron/folate supplementation was more than that with supplementation of iron/folate alone . CONCLUSIONS Considering compliance , feasibility and cost-factors , a public-health approach consisting of once-weekly distribution of iron/folate supplementation through schools and welfare centers is better and can be recommended as an appropriate strategy for combating anemia in adolescent girls of poor communities in developing countries like India
Therefore , vitamin A supplementation alone may reduce the risk of anemia , by improving hemoglobin and ferritin levels in individuals with low serum retinol levels
ABSTRACT Anemia is a worldwide public health problem that can be related to many causes , including vitamin A deficiency .
The aim of this study was to assess and estimate the effect of vitamin A supplementation ( VAS ) on iron status biomarkers and anemia in humans .