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Happy Fish: A Novel Supplementation Technique to Prevent Iron Deficiency Anemia in Women in Rural Cambodia

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dc.contributor.advisor Summerlee, Alastair
dc.contributor.advisor Dewey, Cate
dc.contributor.author Charles, Christopher
dc.date.accessioned 2013-03-15T12:47:14Z
dc.date.available 2013-03-15T12:47:14Z
dc.date.copyright 2012-04
dc.date.created 2012-04-10
dc.date.issued 2013-03-15
dc.identifier.uri http://hdl.handle.net/10214/5927
dc.description.abstract Maternal and child undernutrition are a significant problem in the developing world, with serious consequences for human health and socio-economic development. In Cambodia, 55% of children, 43% of women of reproductive age, and 50% of pregnant women are anemic. Current prevention and control practices rely on supplementation with iron pills or large-scale food fortification, neither of which are affordable or feasible in rural Cambodia. In the study areas, 97% of women did not meet their daily iron requirements. The current research focuses on the design and evaluation of an innovative iron supplementation technique. A culturally acceptable, inexpensive and lightweight iron ingot was designed to resemble a fish species considered lucky in Khmer culture. The ingot, referred to as ‘try sabay’ or ‘happy fish’, was designed to supply iron at a slow, steady rate. Iron leaching was observed in water and soup samples prepared with the iron fish when used concurrently with an acidifier. More than 75% of daily iron requirements can be met with regular use. Its use in the common pot of soup or boiled water provides supplementation to the entire family. The effectiveness of the iron fish was investigated in a randomized community trial involving 310 women in rural Cambodia. Blood samples were taken at baseline and every three months thereafter, over a 12-month trial period. Significant increases in hemoglobin concentrations were observed in women allocated an iron fish when compared to controls throughout the study, with an endline difference of 11.6 g/L. Significant improvements in serum ferritin concentration were observed at 9 months (6.9 ng/mL) and endline (30.8 ng/mL) in women who used an iron fish regularly when compared to the control group. Overall, use of the iron fish led to a two-fold reduction in the prevalence of anemia. The supplement was used daily by 94% of the households at the end of the trial. The study highlights the acceptability and effectiveness of a fish-shaped iron ingot as a means of improving dietary iron content. It offers a promising, simple solution to iron deficiency anemia if the project can be scaled-up for use throughout the country. en_US
dc.description.sponsorship Canadian Institutes of Health Research; International Development Research Centre; University of Guelph en_US
dc.language.iso en en_US
dc.publisher University of Guelph en_US
dc.subject Anemia en_US
dc.subject Nutrition en_US
dc.subject Iron Fish en_US
dc.subject Cambodia en_US
dc.subject Randomized controlled trial en_US
dc.title Happy Fish: A Novel Supplementation Technique to Prevent Iron Deficiency Anemia in Women in Rural Cambodia en_US
dc.type Thesis en_US
dc.degree.programme Biomedical Sciences en_US
dc.degree.name Doctor of Philosophy en_US
dc.degree.department Department of Biomedical Sciences en_US
dc.rights.license All items in the Atrium are protected by copyright with all rights reserved unless otherwise indicated.
dc.degree.grantor University of Guelph en_US


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