Hemoglobin Response to 12 Weeks of Iron Supplementation is Substantially Lower among Non‐Pregnant Cambodian Women with Genetic Hemoglobin Disorders
Notice bibliographique
Résumé
Objective We measured the effect of 12 wk of oral iron (Fe) with or without multiple micronutrients (MMN) on hemoglobin (Hb) response (Hb increase of ≥10 g/L) among Cambodian women of reproductive age screened as anemic. Methods In this 2×2 factorial double‐blind randomized controlled supplementation trial, 2,846 non‐pregnant women (18–45 y) were convenience sampled from 26 rural villages in Kampong Chhnang province, Cambodia. Those ( n =809) with Hb ≤117 g/L (capillary blood, HemoCue® 301) were randomized to 12 wk of daily oral Fe (60 mg elemental), MMN (14 nutrients excluding Fe), Fe+MMN, or placebo capsules. Results Baseline anemia prevalence (Hb <120 g/L) was 58% ( n =468/808) based on a Sysmex hematology analyzer (venous blood collected 1 wk post HemoCue® screening). Baseline iron deficiency was 25% and 22% based on serum soluble transferrin receptor (>8.3 mg/L) and inflammation‐adjusted ferritin (<15 μg/L), respectively. Overall, 74% of women ( n =596/808) had a genetic Hb disorder (primarily, Hb E variants and α‐thalassemia). Of all women who received Fe (with or without MMN), 25% ( n =95/383) responded with an Hb increase ≥10 g/L at 12 wk; among women confirmed anemic using the Sysmex analyzer, 37% ( n =85/232) responded. Among women with depleted iron stores at baseline (ferritin <15 μg/L) who received Fe (with or without MMN), 67% ( n =57/85) had an Hb response ≥10 g/L at 12 wk. The proportion of women with an Hb increase ≥10 g/L at 12 wk was substantially lower among women with a genetic Hb disorder who received Fe (with or without MMN) (18%, n =53/287), as compared to women with no Hb disorder who received Fe (with or without MMN) (44%, n =42/96). There were no significant differences in the proportions of Hb responders and non‐responders in the MMN and placebo groups, by baseline iron status (iron‐depleted or replete) or by the presence/absence of a genetic Hb disorder. Conclusion The proportion of anemia amenable to iron supplementation among our surveyed population of women (~37%) is at the low end of the 95% CI of the estimate for Southeast Asia (45% [95% CI: 35%, 53%]) as reported in the 2011 WHO Global Prevalence of Anemia Report. The proportion of Hb responders among women with a genetic Hb disorder was substantially lower than among women without an Hb disorder (less than half; 18% vs. 44%, respectively), demonstrating that women with an Hb disorder were much less likely to derive benefit from Fe supplementation. We conclude that it is crucial to understand the multifactorial causes of anemia in each country‐specific setting or population (e.g., the prevalence of Hb disorders) in order to design and implement effective anemia reduction strategies and programs. Support or Funding Information Funding was provided by the Micronutrient Initiative, Sight and Life, and the Canadian Institutes of Health Research (CIHR). C.D.K. received a CIHR Vanier Scholarship, a CIHR Michael Smith Foreign Study Supplement, and a Doctoral Research Award from the International Development Research Centre.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».