Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: A systematic review.

BACKGROUND & OBJECTIVE: There is limited evidence regarding the efficacy of iron-containing pots and ingots in reducing iron deficiency (ID) and iron deficiency anemia (IDA) in low- and middle-income countries (LMICs). The objective of this systematic review is to summarize the evidence regarding the effect of iron-containing cookware on ID and IDA among children and females of reproductive age (FRA) in LMICs. METHODS: Searches were last conducted in May 2019 in PubMed, Embase, Cochrane Library, Web of Science, Scopus, CAB Abstracts, POPLINE, LILACS, ProQuest Dissertations & Theses Global, WHO ICTRP and ClinicalTrials.gov. Hand searching was also conducted. Selection criteria included randomized-controlled trials (RCTs), quasi-experimental studies and observational studies with control groups that studied the effect of iron-containing cookware in children (4 months-11 years) and females of reproductive age (12-51 years). RESULTS: Eleven studies were eligible for inclusion in the review. Statistically significant increases in hemoglobin and/or iron indices (p < 0.05) were observed in 50% (4/8) of studies on pots (relative change/mean difference in Hb: -0.4-1.20 g/dL), and 33.3% (1/3) of studies on ingots (relative change/mean difference in Hb: 0.32-1.18 g/dL). Positive outcomes (p < 0.05) were observed among children in 50% (4/8) of studies and among FRA in 28.6% (2/7) of studies. Compliance ranged from 26.7-71.4% daily use of pots to 90-93.9% daily use of ingots. CONCLUSIONS: There are indications that, with reasonable compliance, iron-containing cookware could serve as a means of reducing IDA, especially among children. The potential advantages of iron-containing cookware include relative cost-effectiveness and complementary combination with other interventions. However, further research is needed regarding both the efficacy and safety of this intervention.

Prevalence of anaemia, deficiencies of iron and vitamin A and their determinants in rural women and young children: a cross-sectional study in Kalalé district of northern Benin.

OBJECTIVE: To identify the magnitude of anaemia and deficiencies of Fe (ID) and vitamin A (VAD) and their associated factors among rural women and children. DESIGN: Cross-sectional, comprising a household, health and nutrition survey and determination of Hb, biochemical (serum concentrations of ferritin, retinol, C-reactive protein and α1-acid glycoprotein) and anthropometric parameters. Multivariate logistic regression examined associations of various factors with anaemia and micronutrient deficiencies. SETTING: Kalalé district, northern Benin. SUBJECTS: Mother-child pairs (n 767): non-pregnant women of reproductive age (15-49 years) and children 6-59 months old. RESULTS: In women, the overall prevalence of anaemia, ID, Fe-deficiency anaemia (IDA) and VAD was 47·7, 18·3, 11·3 and 17·7 %, respectively. A similar pattern for anaemia (82·4 %), ID (23·6 %) and IDA (21·2 %) was observed among children, while VAD was greater at 33·6 %. Greater risk of anaemia, ID and VAD was found for low maternal education, maternal farming activity, maternal health status, low food diversity, lack of fruits and vegetables consumption, low protein foods consumption, high infection, anthropometric deficits, large family size, poor sanitary conditions and low socio-economic status. Strong differences were also observed by ethnicity, women's group participation and source of information. Finally, age had a significant effect in children, with those aged 6-23 months having the highest risk for anaemia and those aged 12-23 months at risk for ID and IDA. CONCLUSIONS: Anaemia, ID and VAD were high among rural women and their children in northern Benin, although ID accounted for a small proportion of anaemia. Multicentre studies in various parts of the country are needed to substantiate the present results, so that appropriate and beneficial strategies for micronutrient supplementation and interventions to improve food diversity and quality can be planned.

Effect of a nutrition education program and diet modification in Beninese adolescent girls suffering from mild iron deficiency anemia.

A 26-week nutrition intervention, including 4 weeks of nutrition education, combined with an increase in the content and bioavailability of dietary iron for 22 weeks was carried out in 34 intervention and 34 control adolescent girls suffering from mild iron deficiency anemia (IDA). In post-intervention, hemoglobin and serum ferritin were significantly higher in the intervention group, whereas the incidence of IDA was significantly lower in the intervention group compared to the control group. Nutrition knowledge scores were significantly higher in intervention girls compared to control girls. Dietary changes to improve available dietary iron can reduce iron deficiency anemia.

Impact of socioeconomic and health related factors on the iron status of adolescent girls from two boarding schools in Southern Benin.

UNLABELLED: To our knowledge, the impact of socioeconomic and health related factors on the iron status of adolescent girls has never been studied in Benin. OBJECTIVE: These factors were studied in 180 girls aged 12 to 17 years living in two boarding schools from South Benin. METHODS: Iron deficiency (ID) was defined as either serum ferritin (SF) < 20 microg/L or SF between 20-50 microg/L plus two abnormal values in the three following parameters: serum iron < 11 micromol/L, total iron binding capacity > 73 micromol/L or transferrin saturation < 20%. Socioeconomic and health related factors were obtained from each participant by mean of an interview using a standardized and pre-tested questionnaire. RESULTS: Almost half the participants reported some health problems in the last four months before the study, whereas more than 75% auto-medicated before going to the hospital. The majority of the girls believed themselves to be in good health, although only 16% could define the term 'anemia'. Multivariate regression analysis indicated that girls whose mother was a manual worker (P = .002), who came from a larger family (P = .0001), and who auto-medicated (P = .014), had a lower hemoglobin level, whereas girls who had started their menstruation (P = .008) had a lower SF level. In a logistic regression analysis, girls from a large family size and whose mother was a manual worker showed a higher risk of IDA (OR = 3.5; 95% CI = 1.1-2.5; P = .04; OR = 3.0; 95% CI = 1.2-2.2; P = .04 respectively). CONCLUSION: The findings indicate that iron deficiency is related to the occupation of the mother, family size, auto-medication, and menstruation.