Anthelminthic treatment raises plasma iron levels but does not decrease the acute-phase response in Jakarta school children.

The study was conducted to investigate the impact of intestinal helminthiasis and treatment on iron status and acute phase response (APR) among urban Indonesian primary school children, aged 8-11 years old. The prevalence of helminthiasis among these children was; Ascaris lumbricoides, 81.6%; Trichuris trichiura, 88.3%; and mixed infection of A. lumbricoides and T. trichiura, 70.0%. Of 120 children enrolled in the investigation, 59 received a single 400 mg dose of albendazole, and 61 received a placebo. Ten days following treatment, the prevalence of ascariasis and trichuriasis in the treatment group diminished to 0% and 27%, respectively, and in the placebo group to 63.9% and 68.9%. Plasma iron, hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF) concentrations were determined prior to the intervention and 10 days after. Plasma iron concentrations and WBC count rose in the treatment group (p=< or =0.05) when compared to baseline status. Increases in hemoglobin concentrations observed in the treatment group 10 days post-treatment were not statistically significant. CRP, IL-1, IL-6 and TNF were found to be within normal limits for both groups both before and after treatment. ESR increased significantly in both treatment and placebo groups when compared the rates measured before treatment. These findings show that treatment with albendazole is associated not only with a decreased worm burden in school children, but also a rise in plasma iron.

Relative bioavailability of iron from two different iron tablets used in the Indonesian Iron Supplementation Program.

The relative bioavailability of two different iron tablets which are used in the Indonesian iron supplementation program was determined, because low bioavailability of iron might decrease the impact of the program. In two studies volunteers (n = 12, n = 6) received 120 mg elemental iron either as two iron tablets, each containing 60 mg elemental iron, or as an aqueous Fe(II)-sulphate solution in a randomized cross-over design. Plasma iron concentrations were measured before, and 1, 2, 4, 6, 8 and 10 hours after dosing. For each of the tablets and solutions, the positive area under the concentration/time curve (AUC+), the peak plasma level (Cmax), the time to reach the peak plasma level (tmax) and the relative bioavailability were determined. Relative bioavailability of both tablets was high (106.9 +/- 24.3%) and 116.3 +/- 43.1%). This indicates a good therapeutical efficacy of both tablets. In case where low effectiveness of iron supplementation programs is recorded, factors other than low bioavailability of iron in the tablets must be responsible.