A micronutrient-fortified beverage prevents iron deficiency, reduces anemia and improves the hemoglobin concentration of pregnant Tanzanian women

Maternal malnutrition continues to be a major contributor to adverse reproductive outcomes in developing countries, despite longstanding efforts to fortify foods or to distribute medicinal supplements to pregnant women. The objective of this study was to test the effect of a micronutrient-fortified beverage containing 11 micronutrients (iron, iodine, zinc, vitamin A, vitamin C, niacin, riboflavin, folate, vitamin B-12, vitamin B-6 and vitamin E) on the hemoglobin, iron and vitamin A status of pregnant women in Tanzania. A group of 259 pregnant women with gestational ages of 8 to 34 wk were enrolled in a randomized double-blind controlled trial in which study women received 8 wk of supplementation. Hemoglobin, ferritin and dried blood spot retinol were measured at baseline and at the end of the supplementation period. The supplement resulted in a 4.16 g/L increase in hemoglobin concentration and a 3 micro g/L increase in ferritin and reduced the risk of anemia and iron deficiency anemia by 51 and 56%, respectively. The risk of iron deficiency was reduced by 70% among those who had iron deficiency at baseline and by 92% among those who had adequate stores. The micronutrient-fortified beverage may be a useful and convenient preventative measure, one that could help improve the nutritional status of women both before and during pregnancy and thereby help avoid some of the potential maternal and fetal consequences of micronutrient deficiencies.

Prevalence and type of anaemia in female cotton mill workers in Beijing, China

The present study investigates the prevalence and type of anaemia in Chinese female cotton mill workers. The prevalence of anaemia is reported in 447 non-pregnant female workers aged between 19 and 45 years. The mean value for haemoglobin (Hb) was 123 (SD 15) g/l and 150 of the total 447 subjects had Hb values below 120 g/l; thus 34% of the population was anaemic according to World Health Organization (WHO, 1975) criteria. The mean value for free erythrocyte protoporphyrin (FEP) was 419 (SD 215) micrograms/l; 55% of the total population had FEP values higher than 350 micrograms/l and 72% among the anaemic subjects. Serum ferritin (SF) was tested in all the women with a Hb value less than 120 g/l and 71% of them had SF values below 12.0 micrograms/l. Eighty women diagnosed as either Fe deficient or with Fe-deficient anaemia were selected for a diagnostic supplementation trial. They were randomly assigned to FeSO4 (60 or 120 mg Fe/d) or placebo treatment for 12 weeks. Fe supplementation increased mean Hb values from 114 to 127 g/l (P < 0.001) and SF levels from 9.7 to 30.0 micrograms/l (P < 0.001), and decreased mean FEP values from 570 to 277 micrograms/l (P < 0.001). The response rate of Hb in the whole Fe-treated group or Fe-treated subjects with an Hb level less than 120 g/l was 90% or 92% respectively. These findings indicate that the type of anaemia in this population was mainly Fe deficiency. It was also found that in this population the severity of anaemia, not the prevalence, was significantly related to the use of intra-uterine devices (IUD).

A biotin-avidin enzyme immunoassay for the quantitation of serum ferritin

A biotin-avidin enzyme immunoassay (EIA) for measurement of ferritin in human serum is described. This procedure involves the use of specific antibody immobilized on beads, biotin-labeled specific antibody and enzyme-labeled avidin. Reproducible results were achieved within 2 h for ferritin in serum in the range of 5-500 ng/ml. Ferritin levels as low as 0.1 ng/ml can be measured. The biotin-avidin EIA, a radioimmunoassay kit, and an EIA kit were used to determine serum ferritin levels in healthy adults. Good agreement was found between the biotin-avidin EIA and the other methods.

The laboratory evaluation of microcytic red blood cells

Microcytic red blood cell states are common clinical problems in both adult and pediatric age groups. The recent widespread availability of electronic blood cell counters for performing routine blood counts has increased the detection of microcytic red blood cells. Physicians must workup both symptomatic and asymptomatic patients with microcytic red blood cells before they can initiate proper therapy and/or counseling. The purpose of this review is threefold: (1) to discuss the causes of microcytic red blood cells in terms of disorders of decreased heme production vs. disorders of decreased globin production, (2) to review the clinical laboratory tests useful in differentiating microcytic red blood cell states, and (3) to present a practical approach for the laboratory workup of microcytic red blood cells.