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Iron+folic acid and zinc supplementation and malaria infection affect the development of Zanzibari children 5–9 mo old
Author(s) -
Olney Deanna Kelly,
Pollitt Ernesto,
Kariger Patricia K,
Khalfan Sabra S,
Tielsch James M,
Sazawal Sunil,
Black Robert,
Allen Lindsay H,
Stoltzfus Rebecca J
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a681-b
Subject(s) - malaria , hemoglobin , incidence (geometry) , medicine , zinc , folic acid , pediatrics , physiology , zoology , biology , immunology , chemistry , mathematics , organic chemistry , geometry
Structural equation modeling was used to test the fit of a theoretical model to longitudinal data and examine the direct and indirect effects of daily supplementation with iron (12.5 mg) + folic acid (50 μg) (FeFA), zinc (10 mg) (Zn) and FeFA+Zn and malaria infection on health and development outcomes in 106 children. Change in hemoglobin (Hb) and height (HAZ) after 6 mo of treatment, motor development (MD), motor activity (MA), carrying (Cari), fussing (Fuss) and exploration (Ex) after 9 mo and language development (LD) after 12 mo of treatment, and the relationships among these outcomes were evaluated. Hb, HAZ and malaria (positive blood smear) were collected using standard methods. MA, Cari, Fuss, Ex were assessed from 3 h continuous home observations and LD from parental report. MD was defined as days to walking unassisted since baseline. The interaction of FeFA*Zn positively affected MD (b=−0.34) and FeFA negatively affected LD (b=−0.19). Incidence of malaria negatively predicted Hb (−0.34), MD (0.29) and LD (−0.20) and indirectly predicted MA (b=−0.14), Fuss (b=0.16) and Cari (b=0.21). MA was negatively associated with Fuss (b=−0.35) and Cari (b=−0.23) and positively predicted Ex (b=0.24) and LD (b=0.27). The theoretical model was a good fit to the data and revealed that the incidence of malaria had negative effects on the majority of the health and development outcomes. Funded by Gates Foundation and USAID.