1. Hepcidin-guided screen-and-treat interventions against iron-deficiency anaemia in pregnancy: a randomised controlled trial in The Gambia
- Author
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James H. Cross, Carla Cerami, Andrew M. Prentice, Morgan M. Goheen, Ebrima A. Sise, Sophie E. Moore, Rita Wegmüller, Andrew E. Armitage, Hans Verhoef, Sant-Rayn Pasricha, Amat Bah, Saikou Sanyang, Hal Drakesmith, Ebrima Danso, and Abdul Khalie Muhammad
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Anemia ,Iron ,030231 tropical medicine ,Population ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,Hepcidins ,law ,Pregnancy ,Medicine ,Life Science ,Humans ,Mass Screening ,030212 general & internal medicine ,Adverse effect ,education ,Mass screening ,Global Nutrition ,education.field_of_study ,Wereldvoeding ,Anemia, Iron-Deficiency ,business.industry ,lcsh:Public aspects of medicine ,Pregnancy Complications, Hematologic ,lcsh:RA1-1270 ,General Medicine ,Iron deficiency ,medicine.disease ,3. Good health ,Trace Elements ,Regimen ,Treatment Outcome ,Dietary Supplements ,Female ,Gambia ,business - Abstract
Summary: Background: WHO recommends daily iron supplementation for pregnant women, but adherence is poor because of side-effects, effectiveness is low, and there are concerns about possible harm. The iron-regulatory hormone hepcidin can signal when an individual is ready-and-safe to receive iron. We tested whether a hepcidin-guided screen-and-treat approach to combat iron-deficiency anaemia could achieve equivalent efficacy to universal administration, but with lower exposure to iron. Methods: We did a three-arm, randomised, double-blind, non-inferiority trial in 19 rural communities in the Jarra West and Kiang East districts of The Gambia. Eligible participants were pregnant women aged 18–45 years at between 14 weeks and 22 weeks of gestation. We randomly allocated women to either WHO's recommended regimen (ie, a daily UN University, UNICEF, and WHO international multiple-micronutrient preparation [UNIMMAP] containing 60 mg iron), a 60 mg screen-and-treat approach (ie, daily UNIMMAP containing 60 mg iron for 7 days if weekly hepcidin was
- Published
- 2019