Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia

Soewondo, Soesmalijah; Husaini, M. A.; Pollitt, Ernesto

doi:10.1093/ajcn/50.3.667

Cited by 157 publications

(122 citation statements)

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“…It is known that geohelminth infections are associated with iron deficiency anemia 2 and that iron deficiency anemia influences attention, memory, and learning processes. 3 The tests chosen measured attention, short-term and long-term memory, and learning processes. A test for assessing the intelligence of the children was also used.…”

Section: Methodsmentioning

confidence: 99%

The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides.

Hadidjaja¹,

Bonang²,

Suyardi³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. The prevalence rate of ascariasis in primary school children in northern Jakarta, Indonesia varies from 60% to 90%. An association between helminthic infection and educational achievement has long been recognized. This study was carried out in the northern part of Jakarta among primary school children 6-8 years of age. Treatment of ascariasis and health education were used as the interventions. Before the interventions, basic data on socioeconomic status, epidemiology, infection with Ascaris lumbricoides, nutritional status, and cognitive function were collected. After the interventions, only data on infection with A. lumbricoides, nutritional status, and cognitive function were collected. The children were divided into five groups. Group I was given an anthelminthic (mebendazole), group II was provided with health education, group III was given an antihelminthic and provided with health education, group IV was given a placebo (controls), and group V consisted of egg-negative children, who also served as controls. Data from 336 students were analyzed by analysis of covariance. Parasitologic examinations showed a mean prevalence rate of 58.4% for A. lumbricoides infection in the pre-intervention children and a mean prevalence rate of 40.6% in the post-intervention children. Concerning nutritional status, approximately 80% of the children showed good scores in the pre-and post-treatment data, and only a small percentage (0.9-16.2%) showed mild or moderate malnutrition. No significant difference was found between the pre-and post-treatment nutritional status. The results of the cognitive test showed that the group treated with mebendazole showed significant improvement in the Colored Progressive Matrices and Coding test. Children also showed an improvement in their learning ability, concentration, and eye-hand coordination after five months of receiving this intervention.The prevalence of Ascaris lumbricoides infection in urban slum areas of Jakarta, Indonesia is high, especially in primary school children, in whom it ranges from 60% to 90% (Ismid IS and others, unpublished data). School children were reported to have the highest prevalences and intensities of these geohelminth infections, 1 which result in morbidity, malnutrition, and iron deficiency anemia. 2 An association between iron deficiency anemia and malnutrition in Indonesia has demonstrated their possible contribution to impaired cognitive function and educational achievement. 4 A correlation between helminthic infection and educational achievement has long been recognized. 5,6 However, it is unclear whether these relationships are causal or result from differences in socioeconomic status. 7 This paper reports the results of a study using an experimental design with two types of interventions, namely, the administration of an anthelmintic and health education. The objective of this study was to examine whether infection with A. lumbricoides in school children correlates with nutritional status and cognitive function. MATERIALS AND METHODSStudy...

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Section: Methodsmentioning

confidence: 99%

The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides.

Hadidjaja¹,

Bonang²,

Suyardi³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…There is evidence that cognitive functions and school achievement are improved with iron treatment in iron-de®cient anaemic children Soewondo et al, 1989;Seshadri & Gopaldas, 1989).…”

Section: Introductionmentioning

confidence: 99%

Nutrition, anaemia, geohelminth infection and school achievement in rural Jamaican primary school children

Powell

Walker

et al. 1997

Eur J Clin Nutr

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Objective: To determine whether nutritional status, anaemia and geohelminth infections were related to school achievement and attendance in Jamaican children. Design: A cross-sectional study using a randomly selected sample. Subjects: Eight hundred children aged 9±13 y randomly selected from those enrolled in grade 5 in 16 primary schools in rural Jamaica. Results: The mean height-for-age of the children was 70.37 z-score AE 1.0 s.d. with 4.9% having heights-for-agè 72 s.d. of the NCHS references. Anaemia (Hb`11 g/dl) was present in 14.7% of the children, 38.3% were infected with Trichuris trichiura and 19.4% with Ascaris lumbricoides. Achievement levels on the Wide Range Achievement Test were low, with children performing at grade 3 level. In multilevel analyses, controlling for socioeconomic status, children with Trichuris infections had lower achievement levels than uninfected children in spelling, reading and arithmetic (P`0.05). Children with Ascaris infections had lower scores in spelling and reading (P`0.05) Height-for-age (P`0.01) was positively associated with performance in arithmetic. Ascaris infection (P`0.001) and anaemia (P`0.01) predicted poorer school attendance. Conclusion: Despite mild levels, undernutrition and geohelminth infections were associated with achievement, suggesting that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children Sponsorship: Funding was provided by the Commonwealth Caribbean Medical Research Council and the InterAmerican Development Bank.

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“…Micronutrient deficiency not only affects the health and development of people [5][6][7][8][9] , but also hinders the social and economic development of countries. It is estimated that the loss in economic productivity due to iron deficiency in China is more than 3.6% of the gross national product 10 .…”

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confidence: 99%

Iron and zinc deficiencies in China: what is a feasible and cost-effective strategy?

Jin

et al. 2008

Public Health Nutr.

136

123

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In order to prioritise interventions for micronutrient deficiencies in China, the populations affected by iron and zinc deficiencies were assessed based on data from the 2002 China National Nutrition and Health Survey. The costs and costeffectiveness of supplementation, food diversification and food fortification were estimated using the standard World Health Organization ingredients approach. Results indicated that 30% of children (,2 years), adults (.60 years), pregnant and lactating women, and 20% of women of reproductive age were anaemic, some 245 million people. Approximately 100 million people were affected by zinc deficiency (zinc intake inadequacy and stunting), the majority living in rural areas. Among interventions on iron and zinc deficiency, biofortification showed the lowest costs per capita, I$0.01 (international dollars), while dietary diversification through health education represented the highest costs at I$1148. The costeffectiveness of supplementation, food fortification and dietary diversification for iron deficiency alone was I$179, I$66 and I$103 per disability-adjusted life-year (DALY), respectively. Data for biofortification were not available. For zinc deficiency, the corresponding figures were I$399, I$153 and I$103 per DALY, respectively. In conclusion, iron and zinc deficiencies are of great public health concern in China. Of the two long-term intervention strategies, i.e. dietary diversification and biofortification with improved varieties, the latter is especially feasible and cost-effective for rural populations. Supplementation and fortification can be used as short-term strategies for specific groups. Keywords Micronutrient deficiencyIron Zinc Cost-effectiveness ChinaThe latest World Health Organization (WHO) estimates reveal that undernutrition is an underlying cause of 53% of all deaths in children ,5 years of age 1 . It has been estimated that more than 2 billion of the world's population, nearly all in developing countries, are irondeficient 2,3 . Billions of individuals are also at risk for zinc deficiency 4 . Micronutrient deficiency not only affects the health and development of people 5-9 , but also hinders the social and economic development of countries. It is estimated that the loss in economic productivity due to iron deficiency in China is more than 3.6% of the gross national product 10 .The causes of micronutrient deficiencies include inadequate intakes, impaired absorption and/or utilisation, excessive losses, increased physiological need or the combination of these factors 11 . Insufficient intake and poor bioavailability are major causes in developing countries [12][13][14] . Micronutrient content and bioavailability can be improved by either increasing the quantity of a micronutrient or increasing enhancing factors/decreasing inhibiting factors in foods using different techniques or sources. Strategies for increasing the effective supply of nutrients fall into two categories, supplementation and food-based approaches. Supplementation is the addition of ...

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Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia

Cited by 157 publications

References 5 publications

The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides.

The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides.

Nutrition, anaemia, geohelminth infection and school achievement in rural Jamaican primary school children

Iron and zinc deficiencies in China: what is a feasible and cost-effective strategy?

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