Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area

Abstract

Aim: To study impact of once weekly iron supplementation on praziquantel cure rate, Schistosoma haematobium reinfection, and haematological parameters in pupils aged between 9 and 15 years of age in Nchelenge district, Zambia.

Methods: Pupils in the intervention group received once weekly dose of ferrous sulphate at 200 mg while those in the control received once weekly vitamin C at 100 mg for up to 9 months. Both study groups received a single dose of praziquantel at baseline.

Results: S haematobium reinfection intensity was significantly lower in boys in the intervention group than in boys in the control group at 6 months (P < 0.001) and 9 months (P < 0.001) of supplementation. Significantly lower S haematobium reinfection intensity was found in girls in the intervention group than in girls in the control group only at 6 months of supplementation (P = 0.018). Boys in the intervention group were 42% (Adjusted Risk Ratio = 0.58, 95% confidence interval 0.39, 0.86) less likely to be reinfected with S haematobium than in the control group at 6 months follow up.

Conclusion: Once weekly iron supplementation can decrease S haematobium reinfection after 6 months and should be incorporated into school based schistosomiasis control programs in highly endemic areas.

Trial registration: ClinicalTrials.gov NCT00276224.

Figures

Figure 1

S. haematobium infection at baseline, post treatment residual infection at 3 months, and reinfection at 6 and 9 months

Figure 2

S. haematobium intensity (geometric mean) of infection at baseline and 3 months and reinfection at 6 and 9 months follow ups

Figure 3

Mean haemoglobin levels at baseline and 9 months follow up

Figure 4

Mean number of doses of iron/placebo received by each follow up time