Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI = 42.3, 54.8). Moreover, 34% (95% CI = 28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p < 0.01). Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.

Despite the intensive global efforts to control intestinal parasitic infections, the prevalence of soil-transmitted helminth (STH) infections is still very high in many developing countries particularly among children in rural areas. A randomized, double-blind, placebo-controlled trial was conducted on 250 Aboriginal schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200 000 IU) on STH reinfection. The effect of the supplement was assessed at 3 and 6 months after receiving interventions; after a complete 3-day deworming course of 400 mg/daily of albendazole tablets. Almost all children (98.6%) were infected with at least one STH species. The overall prevalence of ascariasis, trichuriasis and hookworm infection was 67.8%, 95.5% and 13.4%, respectively. Reinfection rates of Ascaris, Trichuris and hookworm were high; at 6 months, assessment reached 80% of the prevalence reported before treatment. There were no significant differences in the reinfection rates and intensities of STH between vitamin A supplemented-children and those who received placebo at 3 and 6 months (p > 0.05). Vitamin A supplementation showed no protective effect against STH reinfection and this could be due to the high endemicity of STH in this community. Long-term interventions to reduce poverty will help significantly in reducing this continuing problem and there is no doubt that reducing intestinal parasitic infection would have a positive impact on the health, nutrition and education of these children. This trial was registered at clinicaltrials.gov as NCT00936091 .

Hepatitis B virus (HBV) infection is a major public health problem worldwide, often coexisting with other illnesses like parasitic infections and other chronic diseases. Data on the association of HBV infection with schistosomiasis and diabetes mellitus (DM) is limited. This case-control study was conducted to investigate the seropositivity rate and potential risk factors of HBV, and to examine the association between HBV and schistosomiasis with or without super added DM. Three hundred patients presented themselves to internal medical departments and diabetes centres at different public and private hospitals in Sana’a city, Yemen. Those recruited were then split in to six groups, those being type 1 DM, type 2 DM, schistosomal hepatic fibrosis (SHF), type 1 DM+SHF, type 2 DM+SHF and the control group. Overall, 20% (60/300) of the participants were positive when tested for hepatitis B core total antibody (HBcAb) by ELISA test. There were no significant differences in the positivity rate in terms of group, age or gender of the participants. Univariate and multivariate analyses showed significant associations between HBV seropositivity and a history of jaundice, familial history of SHF, familial history of liver cirrhosis, personal history of schistosomiasisa and a history of using parenteral antischistosomal drugs. On the other hand, no significant association was reported between HBV seropositivity and any DM-related variables. It was also reported that no additional risk was added to the association between HBV seropositivity and SHF when the analysis stratified for DM. In conclusion, HBV is still a highly prevalent infection and support is urgently needed in order to implement effective and integrated preventive measures among the people most likely to be affected. Further studies are required in order to investigate the epidemiology of HBV infection among various communities, and to evaluate its relationship with other diseases.