RESUMO
WHO recommends that anthelmintic treatment be included in strategies to improve maternal nutrition in areas where hookworms are endemic and anaemia is prevalent. At present, few countries have adopted this recommendation, partly owing to the lack of data to support the adverse effects of hookworms on maternal health. A longitudinal study was conducted on 125 women in Sierra Leone (in 1995/96) to measure the impact of single-dose albendazole (400 mg) and daily iron-folate supplements (36 mg iron and 5 mg folate) on haemoglobin and serum ferritin concentration during pregnancy. Women who received both albendazole and iron-folate supplements experienced no significant change (P > 0.05) in the prevalence of anaemia and iron-deficiency anaemia between the first and third trimesters. These prevalence levels significantly increased (P < 0.05) in women who received either albendazole or iron-folate supplements or neither. After controlling for baseline haemoglobin concentration and season, the mean decline in haemoglobin concentration between the first and third trimester in women who received albendazole was 6.6 g/L less than in women who received the control (P = 0.0034). The corresponding value for iron-folate supplements was 13.7 g/L haemoglobin (P < 0.001). The effects of albendazole and iron-folate supplements were additive. These findings lend support to WHO's recommendation for anthelmintic treatment during pregnancy.
Assuntos
Albendazol/administração & dosagem , Anti-Helmínticos/administração & dosagem , Hemoglobinas/análise , Infecções por Nematoides/tratamento farmacológico , Complicações Parasitárias na Gravidez/tratamento farmacológico , Adolescente , Adulto , Anemia Ferropriva/sangue , Anemia Ferropriva/prevenção & controle , Ascaríase/sangue , Ascaríase/tratamento farmacológico , Feminino , Ferritinas/sangue , Ácido Fólico/administração & dosagem , Humanos , Ferro/sangue , Necatoríase/sangue , Necatoríase/tratamento farmacológico , Infecções por Nematoides/sangue , Gravidez , Complicações Hematológicas na Gravidez/sangue , Complicações Hematológicas na Gravidez/prevenção & controle , Complicações Parasitárias na Gravidez/sangue , Tricuríase/sangue , Tricuríase/tratamento farmacológicoRESUMO
A longitudinal study was conducted in Sierra Leone to measure the impact of a single dose anthelminthic (400 mg albendazole) and daily iron-folate supplements (36 g iron and 5 mg folate) on haemoglobin (HG) concentration during pregnancy. After controlling for baseline Hb concentration and season, anthelmintic treatment reduced the decline in haemoglobin concentration between the first and third trimesters by 6.6 g/L (p=0.0034) relative to the control. The corresponding value for iron-folate supplements was 13.7 g/L(p<0.0001) [corrected]. These findings indicate that anthelminthic treatment should be included in strategies to control maternal anaemia in Sierra Leone.