1. Effects of long-term weekly iron and folic acid supplementation on lower genital tract infection - a double blind, randomised controlled trial in Burkina Faso
- Author
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Loretta Brabin, Umberto D'Alessandro, Adama Kazienga, Sayouba Ouedraogo, Yves Claeys, Stephen A Roberts, Christopher J. Stewart, Andrew Nelson, Salou Diallo, E. Brian Faragher, Halidou Tinto, Bernard J. Brabin, Julia Birtles, Sabine Gies, Other departments, and Global Health
- Subjects
0301 basic medicine ,lcsh:Medicine ,B200 ,wh_160 ,B400 ,Adolescents ,Reproductive Tract Infections ,0302 clinical medicine ,Pregnancy ,Antibiotics ,Prevalence ,qu_188 ,030212 general & internal medicine ,Lower genital tract infection ,wh_155 ,Vaginal flora ,C100 ,wj_100 ,Anemia ,Prenatal Care ,General Medicine ,Iron deficiency ,C500 ,C700 ,3. Good health ,medicine.anatomical_structure ,Cohort ,Vagina ,Female ,Bacterial vaginosis ,Research Article ,medicine.medical_specialty ,Adolescent ,wj_151 ,Iron ,B100 ,Prenatal care ,B300 ,03 medical and health sciences ,Folic Acid ,Double-Blind Method ,Internal medicine ,Burkina Faso ,medicine ,Humans ,Gynecology ,business.industry ,lcsh:R ,qs_4 ,qu_145 ,A300 ,medicine.disease ,Malaria ,030104 developmental biology ,Dietary Supplements ,business ,Follow-Up Studies - Abstract
Background Provision of routine iron supplements to prevent anaemia could increase the risk for lower genital tract infections as virulence of some pathogens depends on iron availability. This trial in Burkina Faso assessed whether weekly periconceptional iron supplementation increased the risk of lower genital tract infection in young non-pregnant and pregnant women. Methods Genital tract infections were assessed within a double blind, controlled, non-inferiority trial of malaria risk among nulliparous women, randomised to receive either iron and folic acid or folic acid alone, weekly, under direct observation for 18 months. Women conceiving during this period entered the pregnancy cohort. End assessment (FIN) for women remaining non-pregnant was at 18 months. For the pregnancy cohort, end assessment was at the first scheduled antenatal visit (ANC1). Infection markers included Nugent scores for abnormal flora and bacterial vaginosis (BV), T. vaginalis PCR, vaginal microbiota, reported signs and symptoms, and antibiotic and anti-fungal prescriptions. Iron biomarkers were assessed at baseline, FIN and ANC1. Analysis compared outcomes by intention to treat and in iron replete/deficient categories. Results A total of 1954 women (mean 16.8 years) were followed and 478 (24.5%) became pregnant. Median supplement adherence was 79% (IQR 59–90%). Baseline BV prevalence was 12.3%. At FIN and ANC1 prevalence was 12.8% and 7.0%, respectively (P
- Published
- 2017
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