ADHERENCE TO IRON SUPPLEMENTATION DURING PREGNANCY IN TANZANIA - DETERMINANTS AND HEMATOLOGIC CONSEQUENCES

Limited adherence to iron supplementation is thought to be a major rea son for the low effectiveness of anemia-prevention programs. In rural Tanzania, women at 21-26 wk of gestation were randomly given either 12 0 mg of a conventional (Con) iron supplement or 50 mg of a gastric-del ivery-system (GDS) iron supplement for 12 wk. Adherence was assessed b y using a pill bottle equipped with an electronic counting device. Adh erence in the GDS group was 61% compared with 42% for the Con group. T n both groups, women experiencing side effects had about one-third low er adherence. Fewer side effects were observed in the GDS group. In a subgroup of women with a low initial hemoglobin concentration (less th an or equal to 120 g/L), the response to the iron supplements suggeste d that both of the applied doses were unnecessarily high for adequate hematologic response in a population with a marginal hemoglobin concen tration. The GDS group appeared to require a dose one-fourth as high a s that of the Con group far an equal effect on improving hemoglobin to normal concentrations.