Albendazole therapy and reduced decline in haemoglobin concentration during pregnancy (Sierra Leone)

WHO recommends that anthelmintic treatment be included in strategies to imp rove maternal nutrition in areas where hookworms are endemic and anaemia is prevalent. At present, few countries have adopted this recommendation, par tly owing to the lack of data to support the adverse effects of hookworms o n maternal health. A longitudinal study was conducted on 125 women in Sierr a Leone (in 1995/96) to measure the impact of single-dose albendazole (400 mg) and daily iron-folate supplements (36 mg iron and 5 mg folate) on haemo globin and serum ferritin concentration during pregnancy. Women who receive d both albendazole and iron-folate supplements experienced no significant c hange (P > 0.05) in the prevalence of anaemia and iron-deficiency anaemia b etween the first and third trimesters. These prevalence levels significantl y increased (P < 0.05) in women who received either albendazole or iron-fol ate supplements or neither. After controlling for baseline haemoglobin conc entration and season, the mean decline in haemoglobin concentration between the first and third trimester in women who received albendazole was 6.6 g/ L less than in women who received the control (P = 0.0034). The correspondi ng value for iron-folate supplements was 13.7 g/L haemoglobin (P < 0.001). The effects of albendazole and iron-folate supplements were additive. These findings lend support to WHO's recommendation for anthelmintic treatment d uring pregnancy.