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Baseline Iron Indices as Predictors of Hemoglobin Improvement in Anemic Vietnamese Women Receiving Weekly Iron-Folic Acid Supplementation and Deworming

Iron deficiency anemia is highly prevalent among women living in rural Vietnam. However, the utility and cut-offs of indices for diagnosing iron deficiency anemia in the public health context is ill defined. We assessed the ability of iron indices to predict the hemoglobin response (HBR) to weekly iron-folic acid supplementation (WIFS) in anemic rural Vietnamese women. We compared hemoglobin, serum ferritin, and soluble transferrin receptor in a cohort of 221 non-pregnant women of reproductive age before and after 3 months of WIFS and deworming. At baseline, anemia (Hb < 120 g/L) was present in 81/221 (36.7%) of subjects. After 3 months, anemia prevalence fell to 58/221 (26.2%), and the mean hemoglobin change was +3.5 g/L (95% confidence interval, 0.9, 6.6). A hemoglobin response was observed in 50/75 (66.6%) of anemic women. A ferritin cut-off < 30 ng/mL was a more sensitive predictor of response than ferritin < 15 ng/mL.

Received March 26, 2009. Accepted for publication August 27, 2009.

Acknowledgments: The authors acknowledge the ongoing support of Yen Bai People’s Committee, Tran Yen and Yen Binh, Department of Preventive Medicine staff, commune health station staff, the village health workers and their communities, and the women of Tran Yen and Yen Binh who participated in these surveys. The authors thank Christalla Hajisava, who provided editorial comments and formatted the manuscript.

Funding support: This study was funded by Atlantic Philanthropy Incorporated.

^* Address correspondence to Beverley-Ann Biggs, Department of Medicine, University of Melbourne, 4th Level, Clinical Sciences Building, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. E-mail: babiggs{at}unimelb.edu.au

Authors’ addresses: Sant-Rayn Pasricha, Gerard J. Casey, Seema Mihrshahi, Lachlan MacGregor, and Beverley-Ann Biggs, Department of Medicine, University of Melbourne, 4th Level, Clinical Sciences Building, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia, E-mails: santapasricha{at}hotmail.com, gcasey{at}unimelb.edu.au, seemam{at}unimelb.edu.au, lachlan.macgregor{at}pacific.net.au, and babiggs{at}unimelb.edu.au. Tran Q. Phuc and Nong T. Tien, National Institute of Malariology, Parasitology and Entomology, 245 Luong, The Vinh Street, Hanoi, Vietnam, E-mails: tquangphuc{at}yahoo.com and nongthitien{at}yahoo.com. Antonio Montresor, World Health Organization, Hanoi, 63 Tran Hung Dau Street, Hanoi, Vietnam, E-mail: MontresorA{at}wpro.who.int.