铅暴露对儿童体内钙及骨钙素的影响

[目的]研究铅暴露对儿童体内骨钙素的影响,了解重庆市儿童铅污染的状况。[方法]选择重庆市工业区和非工业区的幼儿园,调查了2-7岁儿童804例体内铅暴露情况,并同时观察其体内钙及骨钙素水平。[结果]非工业区儿童体内血铅含量[(65．29±24．74)μg／L]明显低于工业区儿童[(75．29±34．61)μg／L],而血钙则与之相反分别为 (2．53±0．34)、(2．38±0．22)m mol／L。统计分析后认为,铅和钙之间不存在典型的直线相关,而折线(趋势)图显示,血铅和血钙之间呈负相关。非工业区儿童血液中骨钙素含量(11．22±6．01)μg／L远低于工业区儿童(21．20±22．70)μg／L,两者比较差异有非常显著性(P<0．01),且与年龄性别相关。多元回归分析血铅对于骨钙素有一定的影响。[结论]铅可能通过调控儿童体内骨钙素的产生,从而影响儿童体内钙的吸收利用。     

0～2岁儿童低血红蛋白与铅中毒对智能发育的影响

目的：了解铅中毒、低血红蛋白对儿童智能发育的影响及相关性。方法：在城区初级保健门诊随机对201例0～2岁儿童检测血铅、血红蛋白及发育指数。采用CDCC量表，通过智力发育指数（MDI）、心理运动发育指数（PDI）评估儿童智商状况。结果：血铅≥100μg／L32例，占15．92％，其MDI均值为（94．18±9．49），PDI均值为（91．43±10．70）。正常对照组MDI均值为（106．18±16．24），PDI均值为（94．42±12．55），两组相比智力发育有明显差异。血红蛋白≤110g／L24例，占11．94％，均为轻度贫血，其MDI为（102．25±16．50），PDI为（88．95±11．33），两项指标均为低水平，但差异不显著。结论：与轻度贫血相比，铅中毒更能导致婴幼儿智力发育落后，低浓度铅中毒与贫血相关性尚不明显。     

包头市郊区儿童血红蛋白检测结果分析

为了解包头市郊区儿童血红蛋白水平及贫血患病情况,我们于1998年4－5月对包头市郊区6－8岁儿童进行了血红蛋白水平检测。1对象与方法1．1对象：整群抽取包头市郊区6－8岁儿童430名（男212名,女218名）。1．2方法：采用氰化高铁血红蛋白测定法。取肘静脉血,使用721分光光度计测定。1．3诊断标准：6－8岁儿童正常Hb值≥110g／L,轻度贫血Hb值110－90g／L,中度贫血Hb89－60g／L,重度贫血Hb59－30g／L[1]。2结果2．1血红蛋白水平分布及构成比：被检测的6－8岁男女儿童血红蛋白值分布于40－155g／L,其中最高值为154．5g／L,最低值为40…     

蚌埠市儿童营养现状与贫血的调查

营养性贫血是影响儿童健康的常见病之一；为了解我市儿童营养现状及贫血发生情况，我们于1993年“六一”儿童节前对我院管辖的十所幼儿园儿童进行体检、血红蛋白测定。现将资料统计如下：1调查对象、方法1．1对象：幼儿园2～6岁健康儿童2214名．1．2方法：采血部位取左手无名指，用氰化高铁法，应用721型分光光度计测定血红蛋白．1．3诊断标准：贫血诊断标准及分类根据卫生部制定的《小儿四病防治方案》规定：血红蛋白正常值＞110g／L，轻度贫血：90～110g／L，中度贫血：60g～89g／L，重度贫血30g～59g／L，极重度贫血＜30g／L．现时营养…     

六安市儿童营养性贫血调查

为了解我市儿童的贫血状况，对市内12所学校6～8岁的儿童2016名进行了贫血调查，现将调查结果报道如下。1对象与方法市内12所小学6～8岁儿童2016名，男生1012名，女生1004名。采用氰化高铁法测定血红蛋白值，以721型分光光度计测定Hb。贫血诊断标准：Hb≤120g/L，轻度贫血：90g/L～120g/L；中度贫血：60g/L～＜90g/L；重度贫血：30g／L～＜60g/L；极重度贫血：＜30g/L。2结果2．1贫血率：被检儿童2016名，贫血人数为942人，患病率为44．72％；其中轻度贫血902人，占贫血人数的95．75％；中度贫血30人，占4．25％；无重度、极重度贫血。2…     

2004年古县中学生贫血状况调查分析

目的 了解古县中学生贫血状况。方法 2004年3-6月随机抽取古县两所中学的初一至高三年级的在校生进行血红蛋白检测。结果 古县中学生男生Hb均值为(141.17±11.72)g／L,女生为(134.38±10.53)g/L,总贫血率为11.65％。不同年级男生贫血率差异有显著性(p<0.01),以初二年级为最高;不同年级女生贫血率差异无显著性(p>0.1);男生的贫血率10.59％低于女生的贫血率12.98％。结论 针对中学生Hb量值及贫血状况,应加强综合防治措施,促进中学生的健康成长。     

驻北疆部队官兵子女血清微量元素水平分析

目的调查驻北疆高寒地区部队官兵的子女血清微量元素的含量 ,为调整儿童的微量元素营养状况提供依据。方法采用化学显色法检测 ,5～ 7岁学龄前儿童血清铁、铜、锌含量 ,用氧化高铁血红蛋白法测定血红蛋白含量。结果 132名学龄前儿童血清铁、铜、锌的含量分别为(9.92± 3.14 ) μmol·L 1、(12 .6 3± 3.75 ) μmol·L 1、(14 .4 5± 5 .0 3) μmol·L 1,其中低于正常参考值下限者分别占 2 2 .73%、15 .91%、12 .12 % ;血红蛋白的含量为 (112 .9± 6 .2 5 )g·L 1,处于正常水平。其中 ,血红蛋白含量低于 110g·L 1者 31人 ,贫血的发生率为 2 3.4 8%。贫血儿童血清铁、铜、锌含量分别为 (8.6 2± 2 .32 ) μmol·L 1、(11.36± 3.84 ) μmol·L 1、(12 .82± 4 .32 ) μmol·L 1,明显低于正常儿童 (P <0 .0 5 ,P <0 .0 1)。结论北疆高寒地区部分学龄前儿童的贫血发生情况及血清铁、铜、锌等微量元素水平不容乐观 ,应引起足够的重视。     

阿勒泰市哈萨克族小儿贫血与饮食习惯的关系研究

目的了解阿勒泰市3岁以下哈萨克族小儿的贫血患病情况及其影响因素,并为进一步研究提供依据。方法于2014年6月-2015年6月采用整群抽样方法抽取该地区符合研究标准的793名哈萨克族小儿为研究对象,采集基本信息、血样本和饮食习惯等信息,运用统计学方法进行描述和分析。结果1岁组、2岁组和3岁组儿童贫血患病率依次为65．5％、75．4％、52．9％;血红蛋白（HGB）在各年龄组内的水平依次为（101．80±18．95）g／L、（95．80±18．81）g/L、（106．00±21．81）g/L;混合喂养儿童的贫血患病率低于单纯母乳喂养儿童;饮用自来水／渠水的儿童贫血患病率低于饮用井水的儿童;习惯经常喝浓茶或奶茶的儿童贫血患病率明显高于很少或不喝浓茶或奶茶的儿童;习惯经常食用新鲜蔬菜和冬至菜的儿童的患病率低于极少食用者。添加辅食时间在0—3月内、3～6月内、6—9月内和9～12月内的贫血患病率分别为55．9％、64．3％、70．3％和77．4％。结论阿勒泰市哈萨克族儿童的贫血患病率较高,HGB水平在各年龄组之间存在差异,儿童贫血与其特定的饮食习惯和结构有较大关系,早期添加辅食可有效降低贫血的发生和发展。     

陕西农村0~18月龄婴幼儿血清维生素A、铁、锌含量及其与贫血关系的研究

目的 了解陕西部分农村地区0~18月龄婴幼儿血清维生素A、铁、锌状况, 探讨其与血红蛋白含量的关系。方法 采取随机整群抽样的方法对陕西澄城县和富平县农村336名出生至18个月婴幼儿, 检测其血清维生素A、铁、锌状况和血红蛋白含量, 并对贫血与非贫血儿童血清中三种微量元素进行比较。结果 336名0~18个月婴幼儿贫血118例, 贫血检出率为35.12%, 血清维生素A、铁、锌缺乏率分别为67.27%、29.1%和90.9%;贫血组血清VitA、铁、锌的平均含量(0.54 μmol/L、881.21 μg/L, 610.01 μg/L)明显低于非贫血组(0.81 μmol/L、1 227.93 μg/L, 679.40 μg/L), 且差异有统计学意义(P<0.05)。结论 陕西农村地区0~18月龄婴幼儿血清维生素A、Fe、Zn缺乏现象较为普遍, 贫血儿童血清维生素A、铁、锌含量显著低于非贫血儿童, 有显著相关性。     

深圳市宝安区学龄前儿童血红蛋白测定情况分析

目的调查深圳市宝安区学龄前儿童血红蛋白(hemoglobin,Hb)状况,为预防儿童贫血提供科学依据。方法 2010年7月采用分层整群随机抽样方法,抽取深圳市宝安区11所幼儿园1 253名儿童作为调查对象,由经过统一培训的工作人员采用叠氮高铁血红蛋白法进行Hb检测。结果 3~6岁学龄前儿童Hb含量平均(123.74±12.93)g/L;贫血构成以轻度为主,占贫血儿童的93.75%,未发现极重度贫血患儿;不同性别间及本地儿童与外来儿童的贫血患病率差异均无统计学意义(均P>0.05)。结论应加强宣传教育,调整幼儿园儿童饮食结构,纠正不良饮食习惯,预防贫血发生。     

Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a Mexican cohort

The WHO recommends exclusive breast-feeding (EBF) for the first 6 mo of life to decrease the burden of infectious disease. However, some are concerned about the effect of EBF >6 mo on iron status of children in developing countries in which anemia is prevalent. This study examines the risk of anemia in relation to the duration of EBF and maternal anemia in a birth cohort studied between March 1998 and April 2003. All infant birth weights were >or=2.2 kg. All mothers received home-based peer counseling to promote EBF. Infant feeding data were collected weekly. Nurses measured hemoglobin (Hb) values every 3 mo. Hb was measured in 183 infants at 9 mo of age. Anemia at 9 mo was defined as a Hb value <100 g/L. EBF was defined by WHO criteria and ranged in duration from 0 to 31 wk. At 9 mo, Hb (mean +/- SEM) was 114 +/- 0.9 g/L; 23 children (12.5%) had Hb levels <100 g/L. EBF >6 mo, but not EBF 4-6 mo, was associated with increased risk of infant anemia compared with EBF <4 mo (odds ratio=18.4, 95% CI=1.9, 174.0). Maternal anemia was independently (P=0.03) associated with a 3-fold increased risk of infant anemia. These associations were not explained by confounding with other maternal or infant factors. By linear regression, a lower infant Hb at 9 mo was associated with increased EBF duration among mothers who had a history of anemia (beta=-0.07, P=0.003), but not among mothers with no history of anemia. Infants who are exclusively breast-fed for >6 mo in developing countries may be at increased risk of anemia, especially among mothers with a poor iron status; greater attention to this issue is warranted.     

Low hemoglobin level is a risk factor for postpartum depression

The role of maternal anemia in the development of postpartum depression (PPD) is unclear. PPD is a serious disorder that may negatively affect the physical and emotional health of a new mother and her infant. Although psychosocial factors that increase the risk of developing PPD are known, few studies have identified physiologic factors that predispose a woman to PPD. New mothers were visited at home on d 7, 14 and 28 after an uncomplicated labor and delivery. Hemoglobin (Hb) concentration was measured via finger-prick blood at each visit, and the women completed the Center for Epidemiological Studies-Depressive Symptomatology Scale (CES-D) on d 28. There was a negative correlation between Hb concentration on d 7 postpartum and depressive symptoms on d 28 (r = -4.26; P = 0.009). CES-D scores (means +/- SEM) on d 7 of women with normal Hb levels > 120 g/L (12 g/dL) were significantly lower (6.90 +/- 1.04) than those of women with Hb levels < or = 120 g/L (12 g/dL) [16.36 +/- 3.34; t(35) = -3.632, P = 0.001]. Thus, women suffering early postpartum anemia may be at increased risk of developing PPD.     

Micronutrient Sprinkles reduce anemia among 9- to 24-mo-old children when delivered through an integrated health and nutrition program in rural Haiti

We evaluated the effectiveness of a 2-mo treatment of Sprinkles containing 12.5 mg iron, 5 mg zinc, 400 microg vitamin A, 160 microg folic acid, and 30 mg vitamin C in reducing anemia among children 9- to 24 mo old in Haiti. Ten food distribution points (FDP) where children received take-home rations of fortified wheat-soy blend (WSB) were randomly allocated into 2 groups: 1) Sprinkles-WSB (S-WSB) (6 FDP; n = 254), receiving 30 sachets of Sprinkles monthly for 2 mo; and 2) WSB only (WSB) (4 FDP; n = 161), not receiving Sprinkles. At baseline, anemia prevalence [hemoglobin (Hb) < 100 g/L], adjusted for age and sex, was 54 and 39% in S-WSB and WSB groups, respectively. After the 2-mo intervention (1st follow-up), anemia, adjusted for baseline prevalence, age, and sex dropped to 24% in S-WSB (P < 0.001) and increased to 43% in WSB (P = 0.07). At 7 mo postintervention, anemia in S-WSB declined to 14%; 92% of children who were nonanemic at 1st follow-up remained so without further Sprinkles consumption. From baseline to 1st follow-up, mean Hb increased by 5.5 g/L and dropped by 1.0 g/L in the S-WSB and WSB groups, respectively (P < 0.001). From baseline to 2nd follow-up, mean Hb increased by 10.9 g/L in S-WSB (P < 0.001). Changes in mean Hb were greater for younger children (<21 mo at onset of intervention) (P < 0.05) and for children who were anemic at baseline (P < 0.001). In populations with a high prevalence of anemia, such as rural Haiti, 2 mo of Sprinkles are effective in reducing anemia among 9- to 24-mo-old children.     

Once weekly is superior to daily iron supplementation on height gain but not on hematological improvement among schoolchildren in Thailand

Intermittent iron supplementation has been suggested as a replacement for daily iron supplements for reducing anemia in developing countries. The effects of once weekly and daily iron supplementation on hemoglobin (Hb), serum ferritin (SF), prevalence of anemia, weight and height are compared in this study. Primary schoolchildren (n = 397) from two selected schools in the Hat Yai rural area, southern Thailand, were recruited in 1999. All children received Albendazole and then randomly received ferrous sulfate (300 mg/tablet) either daily or weekly, or a placebo for 16 wk. The average increase in Hb was not significantly different between the daily (mean +/- SD; 6.5 +/- 6.0 g/L) and weekly (5.7 +/- 6.3 g/L) groups. However, the average increase in SF was greater (P < 0.01) in the daily (mean +/- SD; 39.8 +/- 30.3 microg/L) than the weekly (13.4 +/- 17.3 microg/L) group. All cases of iron deficiency anemia were abolished in both daily and weekly groups, whereas no reduction in prevalence occurred in the placebo group. Height gain was greater in children who received weekly (mean +/- SD; 2.6 +/- 0.9 cm) than in those who received daily iron (mean +/- SD; 2.3 +/- 0.8 cm), (P < 0.01). Weight gain, weight-for-age and height-for-age were not significantly different among the intervention groups. It is concluded that a weekly iron dose is more effective than a daily dose in height gain but not in hematological improvement over 16 wk of supplementation.     

The high prevalence of low hemoglobin concentration among Indonesian infants aged 3-5 months is related to maternal anemia

Iron deficiency anemia among young children is a large health problem. However, there is little information about the prevalence of anemia among young infants because it has been assumed that normal, breast-fed infants have adequate iron stores until 4-6 mo of age. We analyzed cross-sectional data from the HKI/GOI Nutrition and Health Surveillance System in rural Java, Indonesia from Sept. 1999 to Feb. 2001 for hemoglobin (Hb) of 3- to 5-mo-old breast-fed infants (n = 990) and related factors. The prevalence of Hb < 90 g/L was 13.4%, < 100 g/L, 37%, and < 110 g/L, 71%. Multiple logistic regression analysis revealed that normal birth weight infants (>2500 g) of anemic mothers (Hb < 120 g/L) had an odds ratio (OR) [95% confidence interval (CI)] of 1.81 [1.34-2.43] to have a low Hb (< 100 g/L) compared with infants of nonanemic mothers with a normal birth weight. Infants of nonanemic mothers but with low birth weight had an OR of 1.15 [0.61-2.16], and those with low birth weight and anemic mothers of 3.68 [1.69-8.02]. Other risk factors included stunting (OR 1.70 [0.97-2.95]), a young mother (<20 y, OR 1.54 [0.95-2.49]), lower maternal education and living in West Java or East Java. Considering that maternal postpartum Hb reflects Hb during pregnancy, that anemia among mothers in this population is due mainly to iron deficiency, and that children born to anemic mothers are at higher risk of a low Hb, we hypothesize that low infant Hb in this population is due to iron deficiency. Intervention studies in iron deficient populations should test this hypothesis.     

陕西省黄陵县农村50～75岁妇女贫血危险因素分析

目的 分析陕西省黄陵县农村老年妇女贫血的相关危险因素.方法 以西北地区抽样点陕西省黄陵县50～75岁妇女为研究对象,进行血红蛋白(Hb)筛查和基本健康状况询问,选择200例病例组人员,按年龄1:1配对选择200名对照组人员.对两组的一般状况、饮食情况进行问卷调查,测定相关血液生化指标.结果 贫血组和对照组的个人年收入分别为(446.1±107.9)、(903.8±179.1)元(t=3.06,P＜0.01),平均每天活动时间分别为(9.6±3.2)、(10.3±3.1)h(t=1.94,P＜0.05)、经历食物短缺比例分别为31.8%、22.6%(χ2=4.14,P＜0.05)、腰围分别为(76.2±7.3)、(79.5±8.9)cm(t=4.08,P＜0.01).贫血组和对照组的总蛋白分别为(78.0±5.8)、(81.9±6.0)g/L(t=5.94,P＜0.01)、血清铁分别为(13.9±5.7)、(16.1±5.0)μmol/L(t=4.19,P＜0.01)、铁蛋白分别为(94.9±76.4)、(116.6±85.2)μg/L(t=2.58,P＜0.01)、转铁蛋白饱和度分别为22.9%±10.0%、25.6%±8.7%(t=3.16,P＜0.01).多因素条件logistic回归分析显示,个人年收入、是否经历食物短缺、平均每天活动时间、主食、豆类及其制品、能量的OR值分别为:0.57、4.74、0.06、0.59、0.55、0.65.95%CI分别为0.45～0.71、0.73～30.56、0.01～0.52、0.38～0.91、0.34～0.87、0.44～0.98.结论 黄陵地区老年贫血妇女的膳食质量、体格状况和相关血液指标均低于对照组,收入水平低、活动时间少、主食、豆类及其制品、能量摄入量低为贫血的危险因素.     

Genetic hemoglobin disorders, infection, and deficiencies of iron and vitamin A determine anemia in young Cambodian children

In Cambodia, many factors may complicate the detection of iron deficiency. In a cross-sectional survey, we assessed the role of genetic hemoglobin (Hb) disorders, iron deficiency, vitamin A deficiency, infections, and other factors on Hb in young Cambodian children. Data on sociodemographic status, morbidity, and growth were collected from children (n = 3124) aged 6 to 59 mo selected from 3 rural provinces and Phnom Penh municipality. Blood samples were collected (n = 2695) for complete blood count, Hb type (by DNA analysis), ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), C-reactive protein, and α(1)-acid glycoprotein (AGP). Genetic Hb disorders, anemia, and vitamin A deficiency were more common in rural than in urban provinces (P < 0.001): 60.0 vs. 40.0%, 58.2 vs. 32.7%, and 7.4 vs. 3.1%, respectively. Major determinants of Hb were age group, Hb type, ferritin, sTfR, RBP, AGP >1.0 g/L (P < 0.001), and rural setting (P < 0.05). Age group, Hb type, RBP, elevated AGP, and rural setting also influenced ferritin and sTfR (P < 0.02). Multiple factors affected anemia status, including the following: age groups 6-11.99 mo (OR: 6.1; 95% CI: 4.3, 8.7) and 12-23.99 mo (OR: 2.7; 95% CI: 2.1, 3.6); Hb type, notably Hb EE (OR: 18.5; 95% CI: 8.5, 40.4); low ferritin (OR: 3.2; 95% CI: 2.2, 4.7); elevated AGP (OR: 1.4; 95% CI: 1.2,1.7); rural setting (OR: 2.3; 95% CI: 1.7, 3.1); low RBP (OR: 3.6; 95% CI: 2.2, 5.9); and elevated sTfR (OR: 2.1; 95% CI: 1.7, 2.7). In Cambodia, where a high prevalence of genetic Hb disorders exists, ferritin and sTfR are of limited use for assessing the prevalence of iron deficiency. New low-cost methods for detecting genetic Hb disorders are urgently required.     

Preconception hemoglobin and ferritin concentrations are associated with pregnancy outcome in a prospective cohort of Chinese women

Prenatal anemia and iron deficiency are associated with adverse birth outcomes, but no previous studies have examined the relation between preconception anemia, iron deficiency, and pregnancy outcome in healthy women. We measured hemoglobin (Hb), ferritin, transferrin receptor (TfR), and vitamins B-6, B-12, and folate concentrations before pregnancy in 405 Chinese women (median time from sample collection to gestation end = 316 d). Both mild (95 /=60 microg/L) ferritin were also significantly associated with lower birthweight (106 and 123 g, respectively). The risks of low birthweight (LBW) and fetal growth restriction (FGR) were significantly greater among women with moderate anemia compared with nonanemic controls [odds ratio (OR): 6.5; 95% CI: 1.6, 26.7; P = 0.009 and OR: 4.6; 95% CI: 1.5, 13.5; P = 0.006, respectively]. TfR and low ferritin were not associated with adverse birth outcome, but elevated ferritin, which could be a marker of inflammation, was associated with increased risk of LBW (OR: 2.2; 95% CI: 0.9, 5.7; P = 0.09) and FGR (OR: 2.7; 95% CI: 1.3, 5.6; P = 0.008). Preconception anemia, particularly iron-deficiency anemia, was associated with reduced infant growth and increased risk of adverse pregnancy outcome in Chinese women.     

Regular consumption of NaFeEDTA-fortified fish sauce improves iron status and reduces the prevalence of anemia in anemic Vietnamese women

BACKGROUND: Fish sauce is consumed daily by a large proportion of the Vietnamese population and could therefore be a potentially useful food vehicle for iron-fortification programs. OBJECTIVE: We evaluated the efficacy of iron-fortified fish sauce in improving the iron status of anemic women. DESIGN: In a randomized, double-masked study of 152 anemic (hemoglobin concentration of 81-119 g/L) women, a meal based on noodles or rice was served 6 d/wk with 10 mL fish sauce containing either 10 mg Fe as NaFeEDTA (iron-fortified group) or no added iron (control group). Concentrations of hemoglobin, serum ferritin (SF), and serum transferrin receptor (TfR) were measured at baseline and after 3 and 6 mo. RESULTS: After 6 mo, hemoglobin and SF concentrations were higher and TfR concentrations were lower in the iron-fortified group than in the control group [hemoglobin: 116.3 +/- 8.7 ( +/- SD) compared with 107.6 +/- 11.0 g/L (P < 0.0001); SF: 30.9 (95% CI: 23.4, 40.6) compared with 14.6 (11.3, 19.0) micro g/L (P = 0.0002); TfR: 7.2 (6.4, 7.9) compared with 9.0 (8.1, 9.9) mg/L (P = 0.002)]. The prevalence of iron deficiency (SF < 12 micro g/L or TfR > 8.5 mg/L) and iron deficiency anemia (iron deficiency with hemoglobin < 120 g/L) was lower in the iron-fortified group than in the control group [32.8% compared with 62.5% (P = 0.0005) and 20.3% compared with 58.3% (P < 0.0001), respectively]. CONCLUSIONS: Regular consumption of iron-fortified fish sauce significantly reduced the prevalence of iron deficiency anemia in Vietnamese women during the 6-mo intervention. Fortifying fish sauce with iron by using a water-soluble, highly bioavailable compound (NaFeEDTA) is a promising strategy for combating iron deficiency anemia in Vietnam.     

Daily iron supplementation is more efficacious than twice weekly iron supplementation for the treatment of childhood anemia in western Kenya

A recent meta-analysis of 14 clinical trials indicated that daily compared with intermittent iron supplementation resulted in significantly greater hematological improvement in pregnant women. No such definitive beneficial effect was demonstrated in preschool children. We compared the efficacy of daily and twice weekly iron supplementation for 6 wk under supervised and unsupervised conditions in the treatment of mild and moderate anemia [hemoglobin (Hb) 50-109 g/L] in children aged 2-59 mo living in a malaria-endemic area of western Kenya. The study was a cluster-randomized trial using a factorial design; participants were aware of the treatment assigned. All children (n = 1049) were administered a single dose of sulfadoxine-pyrimethamine at enrollment followed by 6 wk of daily supervised iron supplementation [3-6 mg/(kg.d)], twice weekly supervised iron supplementation [6-12 mg/(kg.wk)], daily unsupervised iron supplementation, or twice weekly unsupervised iron supplementation. In the supervised groups, Hb concentrations at 6 and 12 wk (6 wk postsupplementation) were significantly higher in children given iron daily rather than twice weekly [mean (95% CI) difference at 6-wk: 4.2 g/L (2.1, 6.4); 12-wk: 4.4 g/L (1.8, 7.0)]. Among the unsupervised groups, Hb concentrations were not different at 6 wk [mean (95% CI) difference: 0.86 g/L (-1.4, 3.1)], but significantly higher at 12 wk for those assigned daily iron [mean (95% CI) difference: 3.4 g/L (0.79, 6.0), P = 0.02]. In this malarious area and after initial antimalarial treatment, 6 wk of daily iron supplementation results in better hematological responses than twice weekly iron supplementation in the treatment of anemia in preschool children, regardless of whether adherence can be ensured.