╨╧рб▒с>■  ,;■   -                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴` Ё┐Hbjbj╦s╦s 2(йй&      д║║║║vvvК8J^К.ЖЖЦЦЦ+++КММММММ$Ih▒.░v6''66░║║ЦЦС┼2226j║Ц║ЖЦК26К22║@62Цz ╩(╚к╞аж2V4▀<2▀FО▀2▀v2$+-╕2хФy╜+++░░╘^+++6666КККD╬DККК╬ККК║║║║║║     WEEKLY SUPLEMENTATION OF IRON IN SCHOOL CHILDREN AFFECTED BY THE FLOODS OF SANTA FE CITY. ARGENTINA Introduction: In April 2003 Santa Fe City, in Argentina, suffered the worst flood in the countryТs history, which affected more than 130 thousand people and caused severe material damage. In this context, Acciєn contra el Hambre developed a project to strengthen the nutritional surveillance system, which included carrying on a nutritional survey among children who were less than 6 years old and schoolchildren from the flooded areas of the city. A high presence of anemia was found not only in infants and pre-school children but also in schoolchildren attending first grade (6 years old). Among this last group, the average scores of anemia were above 25%. A strong association between the anemia and the poor school performance and repetitions was also detected. From this data on, it was considered necessary and appropriate to develop an intervention to reduce the risk of nutritional anemia in school children, as well as to carry on the corresponding impact evaluation, in order to be able to make recommendations to the provinceТs authorities. The objective of this study is to present the results obtained with the iron sulfate weekly supplement to school children of Santa Fe City, Argentina. Objectives: To evaluate the impact of the weekly supplement of iron sulfate on the reduction in the prevalence of anemia in school children attending first grade in Santa Fe City and affected by the flood. Material y Methods: The study subjectТs were first grade students attending schools affected by the floods, who were evaluated in August 2003 and accepted to receive the supplement (S), and a group, even though evaluated during the same period of time, but reject the weekly supplement (NS). The group УSФ received, weekly, a 200 mg iron sulfate pill and 0.4 mg of folic acid during 20 weeks. The supplement was delivered at schools and later on, due to the summer break, at homes. In every case, a team of nutritionists and health promotion personnel visited the families once a week, in order to evaluate the fulfillment of the protocol. There were excluded from the program children who presented hemoglobin values below 9 gr/dl. These cases where re-directed to the Health Centers of reference, so as to initiate a daily treatment with iron sulfate. Both groups (S and NS) were evaluated using anthropometric indicators and HB at the end of the research. Results: A total of 440 students were evaluated (379 from the УSФ group and 61 from the УNSФ one). 59% of them received 18 or more doses of supplement, 22% received between 16 and 17 doses and only 16% took less than 16 doses. In the УSФ group the presence of anemia was reduced from 23.7% to 16.8% (p < 0.05), while in the УNSФ went from 6.5% to 24.6% (p < 0.05). Likewise, in the УSФ group, the average values of HB among children with anemia showed a clear recovery, while in those without it the values remained basically the same. On the other hand, it was observed that in order to attain satisfactory results, at least 16 doses were required. From then on, the hemoglobin values increased directly proportional to the number of doses, until reaching 20. It becomes clear that the weekly supplement has been effective not only for the prevention of anemia, as shown in the comparison with the УNSФ group, but also for the treatment of the anemia cases, as with 18 doses or more the recovery percentage reached 74%. Conclusions: As shown by other studies, the weekly supplement resulted effective for both, the treatment and the prevention of anemia. Likewise, a high support from the families and the education community for the students was observed. In that sense, it is considered that this intervention has been the adequate strategy in the short and medium term, so as to give an answer to school children nutritional problems. On the other hand, another survey was conducted at the beginning of year 2005 to a representative sample of schoolchildren from the whole province of Santa Fe, in coordination with the provinceТs health and education authorities, based on the previous one. This research showed values very similar to those reported in this first project and it was therefore decided, together with the education and health ministries, to supplement all the selected schools. Finally, the great significance of the work process conducted together by the state and the civil society for the formulation and execution of programs and public policies assigned to the most vulnerable part of the population has to be emphasized.     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