Effects of weekly iron supplementation on pregnant Indonesian women are similar to those of daily supplementation.

The effect of daily rather than weekly iron supplementation was compared in women who were 8-24 wk pregnant. One group (n = 68) received 60 mg Fe/d, the second group (n = 71) received 120 mg Fe/wk, given at once. Supplementation lasted 11.3 wk on average, depending on gestational date at entry, and was not supervised. Hemoglobin increased in both groups (P < 0.001); serum ferritin did not change significantly. There was no significant difference between groups for changes in hemoglobin and serum ferritin. In a subgroup of women with a hemoglobin concentration < 110 g/L at baseline (n = 45 daily; n = 54 weekly) no significant within-group changes occurred in serum ferritin, but the change in the daily group was 4.1 micrograms/L higher than in the weekly group (P = 0.049). Compliance, as indicated by two positive stool tests, was approximately equal to 54.3% in the daily group and 62.2% in the weekly group. We conclude that for the complete sample of subjects, the treatment effect of daily compared with weekly supplementation was similar under conditions resembling a normal antenatal care program.

Depressed immune response to tetanus in children with vitamin A deficiency.

A randomized, double-masked, placebo-controlled clinical trial was conducted with 236 preschool children, age 3-6 y, in Indonesia to assess immune status in mild vitamin A deficiency. The immune response to tetanus immunization was used as a measure of immune competence. Clinically normal children (n = 118) and children with mild xerophthalmia (n = 118) were randomly assigned to receive oral vitamin A (60,000 micrograms retinol equivalent) or placebo treatment for a total of four study groups. Two weeks after treatment, children were immunized with diphtheria-pertussis-tetanus vaccine. The immunoglobulin G (IgG) responses to tetanus at baseline and 3 wk following immunization were measured by ELISA. After adjusting for previous tetanus immunization, clinically normal and xerophthalmic children receiving vitamin A had a significantly greater IgG response to tetanus than clinically normal and xerophthalmic children receiving placebo (P less than 0.05). These results suggest that children with mild vitamin A deficiency have a relative immune depression compared with children who have been supplemented to normal vitamin A levels.