The effect of iron and multi-micronutrient supplementation on Ascaris lumbricoides reinfection among Zambian schoolchildren

A randomised, placebo-controtted, double-blind trial was conducted among schoolchildren in Chawama, Lusaka, Zambia, to determine the effect of iron and multi-micronutrients on reinfection with Ascaris lumbricoides. Supplementation was given on every school day for 10 months. Baseline A. lumbricoides prevalence and geometric mean intensity among positives were 43.4% and 2526 eggs per gram (epg) faeces, respectively. Serum ferritin <12 mu g/l was associated with higher egg counts than serum ferritin >= 12 mu g/l (4728 vs. 2036 epg, P=0.033). Of 406 children recruited, 378 (93.1%) were examined at baseline and all infected children were treated and cure ascertained. The mean number of tablets taken per week was 2.5, giving 50% compliance. At six months 283 (74.9%) children complied, and reinfection intensities in those receiving iron were lower than in those receiving placebo (1600 vs. 3085 epg, P=0.056). This effect disappeared at 10 months, where 215 (56.9%) complied. Iron had no effect on A. lumbricoides reinfection rates and multi-micronutrients had no effect on reinfection rates or intensities. Iron appears to affect reinfection intensity with A. lumbricoides, but further investigations are required to confirm this effect and elucidate the mechanisms involved. (C) 2008 Published by Elsevier Ltd on behalf of Royal Society of Tropical Medicine and Hygiene.