0081

A RANDOMIZED CONTROL TRIAL TO REDUCE ANEMIA IN MALARIA ZONES

Kevin J Chan, Arman Ramandon, Jason Lee, and Bert Nanninga

Toronto, Canada

 

Introduction: The impact of vitamin C has been documented to reduce anemia. The effects of vitamin A and zinc on anemia in iron-deficient and malaria zones have not been clearly delineated. 

Methods: A randomized control trial for six weeks was conducted from August 1999-March 2000 on children from age one to five. There were 4 different regimens: 1) Vitamin C alone; 2) Vitamin A + Vitamin C; 3) Zinc + Vitamin C; and 4) Vitamin A, Vitamin C, and zinc tablets. All patients were treated with a 3 day course of Mebendazole prior to the start of treatment to eliminate hookworm infection. Iron supplementation was given using Fer-in-sol solution. Institutional approval was given by each participating site. Informed consent was obtained on all participants. All blood samples were taken in the malaria seasons of each country.  Blood was taken at the start and end of treatment, and samples were frozen for analysis.

Results: There were 694 participants. There were 34 participants lost to follow-up for a total of 660 participants.  Compared to the baseline (Vitamin C alone) (15% improvement), the regimens with Vitamin A and Vitamin C, (22% improvement) and Vitamin A, Vitamin C, and zinc (23% improvement), did better (p<0.05) in improving mean Hemoglobin levels.  There was no difference from baseline for zinc and Vitamin C (13% improvement) (p=0.82).

Conclusions: Vitamin A and Vitamin C reduce anemia in malaria zones and impoverished areas, while zinc supplementation has no effect.