Impact of iron supplementation and deworming on growth performance in preschool Beninese children

Objective: To assess the effects of iron and deworming on linear growth performance of preschoolers. Design: Three-month randomized, double-blind and placebo-controlled trial. The children were allocated to four treatments: iron (60 mg elemental iron/day) + albendazole (200 mg/day for 3 consecutive days, repeated 1 month later), iron + albendazole-placebo, albendazole + iron-placebo or placebos. The supplementation was supervised. Subjects: A group of 177 children aged 3-5 y was selected from low-income households in a rural area in southern Benin. A complete data set was analysed for 140 subjects. Many children were stunted (58% had height-for-age Z-score < -2), none were wasted (2% had weight-for-height Z-score < -2) and 76% were anemic (Hb < 110 g/l). Main outcome measures: Anthropometric parameters, hemoglobin and eggs per gram feces. Results: No significant difference in changes in anthropometric parameters was observed between study groups, and also not in a sub-sample of stunted and anemic subjects. Changes in hemoglobin were highest in the iron-treated subjects at the end of the 3-month intervention period (P = 0.032). The difference between the iron and the placebo groups remained significant even 7 months later (P = 0.022). The difference was 5 g/l in both periods. Ascaris lumbricoides and hookworm infections decreased significantly in albendazole-treated subjects (P < 0.05). Conclusions: In addition to recurrent parasitic infection burden, the children may have multiple micronutrient deficiencies. Therefore, it may be interesting to study appetite and food intake of young toddlers in relation to health and linear growth performance in poor environments. Sponsorship: The Nestle Foundation (Lausanne, Switzerland).