{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T21:52:12Z","timestamp":1787003532043,"version":"build-2736575974"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008090","name":"Tufts University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007941","name":"Addis Ababa University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Adequate micronutrient status during adolescence can break the inter-generational cycle of malnutrition. This study evaluated the effect of community-based weekly iron-folic acid supplementation (WIFAS) on serum ferritin (SF), serum folate (SFol) and hemoglobin concentration (Hb) among adolescent girls. A community-based, individually randomized-controlled trial (RCT) was conducted in four villages of Wolaita and Hadiya zones. Adolescent girls (n\u2009=\u2009226) aged 10\u201319\u00a0years were recruited and randomly assigned (n\u2009=\u2009113\/group) into: (i) WIFAS and (ii) control (no intervention) groups. Anthropometry, Hb concentration, and serum ferritin (SF), SFol, and C-reactive protein (CRP) was analyzed at baseline and endline. Baseline Hb, SF, SFol and CRP concentrations were similar in both groups (P\u2009&gt;\u20090.05). About 47\u201349% of adolescents had marginal iron store (&lt;\u200950\u00a0\u00b5g\/l). Hb, SF, and SFol concentrations increased in the intervention group, but not in the control group (P\u2009&lt;\u20090.05). Marginal iron store decreased from 49 to 12% after 3-months of WIFAS; whereas, the proportion of adolescents with elevated SF (&gt;\u200915\u00a0\u00b5g\/l) was slightly higher in the WIFAS than in the control group (P\u2009=\u20090.06). After adjusting for confounding factors in the multiple linear regression model, a three-months WIFAS intervention was associated with an improvement of 4.10\u00a0ng\/ml in serum folate, 39.1\u00a0\u03bcg\/l in serum ferritin, and 1.2\u00a0g\/dl in hemoglobin concentration relative to the control group (P\u2009&lt;\u20090.001). WIFAS intervention for three-months was effective in reducing iron and folate deficiency in adolescent girls. Future studies should evaluate the long-term impact of intermittent WIFAS.<\/jats:p>","DOI":"10.1038\/s41598-021-89115-5","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T06:06:43Z","timestamp":1620281203000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A community-based randomized controlled trial providing weekly iron-folic acid supplementation increased serum- ferritin, -folate and hemoglobin concentration of adolescent girls in southern Ethiopia"],"prefix":"10.1038","volume":"11","author":[{"given":"Yoseph Halala","family":"Handiso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tefera","family":"Belachew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherinet","family":"Abuye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhalik","family":"Workicho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaleab","family":"Baye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"issue":"9809","key":"89115_CR1","doi-asserted-by":"publisher","first-page":"2123","DOI":"10.1016\/S0140-6736(10)62304-5","volume":"378","author":"Y Balarajan","year":"2011","unstructured":"Balarajan, Y. et al. Anaemia in low-income and middle-income countries. The Lancet 378(9809), 2123\u20132135 (2011).","journal-title":"The Lancet"},{"key":"89115_CR2","doi-asserted-by":"publisher","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","volume":"36","author":"NM Abu-Ouf","year":"2015","unstructured":"Abu-Ouf, N. M. & Jan, M. M. The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health. Saudi Med. J. 36, 146 (2015).","journal-title":"Saudi Med. J."},{"key":"89115_CR3","doi-asserted-by":"publisher","first-page":"443S","DOI":"10.1093\/jn\/130.2.443S","volume":"130","author":"TO Scholl","year":"2000","unstructured":"Scholl, T. O. & Reilly, T. Anemia, iron and pregnancy outcome. J. Nutr. 130, 443S-447S (2000).","journal-title":"J. Nutr."},{"key":"89115_CR4","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1080\/10408390701724264","volume":"48","author":"MA Al-Farsi","year":"2008","unstructured":"Al-Farsi, M. A. & Lee, C. Y. Nutritional and functional properties of dates: A review. Crit. Rev. Food Sci. Nutr. 48, 877\u2013887 (2008).","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"89115_CR5","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1056\/NEJMra1401038","volume":"372","author":"C Camaschella","year":"2015","unstructured":"Camaschella, C. Iron-deficiency anemia. N. Engl. J. Med. 372, 1832\u20131843 (2015).","journal-title":"N. Engl. J. Med."},{"key":"89115_CR6","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.12816\/0044770","volume":"70","author":"AS Sharourou","year":"2018","unstructured":"Sharourou, A. S. et al. Anemia: Its prevalence, causes, and management. Egypt. J. Hosp. Med. 70, 1877\u20131879 (2018).","journal-title":"Egypt. J. Hosp. Med."},{"key":"89115_CR7","doi-asserted-by":"publisher","first-page":"756S","DOI":"10.3945\/jn.110.128793","volume":"141","author":"RJ Stoltzfus","year":"2011","unstructured":"Stoltzfus, R. J. Iron interventions for women and children in low-income countries. J. Nutr. 141, 756S-762S (2011).","journal-title":"J. Nutr."},{"key":"89115_CR8","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1590\/S1415-790X2013000300016","volume":"16","author":"JA Cesar","year":"2013","unstructured":"Cesar, J. A. et al. Iron supplementation among pregnant women: Results from a population-based survey study. Rev. Bras. Epidemiol. 16, 729\u2013736 (2013).","journal-title":"Rev. Bras. Epidemiol."},{"key":"89115_CR9","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1177\/004947550003000210","volume":"30","author":"M Young","year":"2000","unstructured":"Young, M. et al. The effectiveness of weekly iron supplementation in pregnant women of rural northern Malawi. Trop. Doct. 30, 84\u201388 (2000).","journal-title":"Trop. Doct."},{"key":"89115_CR10","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s12884-019-2422-4","volume":"19","author":"H Assefa","year":"2019","unstructured":"Assefa, H., Abebe, S. M. & Sisay, M. Magnitude and factors associated with adherence to Iron and folic acid supplementation among pregnant women in Aykel town, northwest Ethiopia. BMC Pregn. Childbirth 19, 296 (2019).","journal-title":"BMC Pregn. Childbirth"},{"key":"89115_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-018-1716-2","volume":"18","author":"M Getachew","year":"2018","unstructured":"Getachew, M. et al. Magnitude and factors associated with adherence to Iron-folic acid supplementation among pregnant women in Eritrean refugee camps, northern Ethiopia. BMC Pregn. Childbirth 18, 1\u20138 (2018).","journal-title":"BMC Pregn. Childbirth"},{"key":"89115_CR12","first-page":"7","volume":"2015","author":"AA Sadore","year":"2015","unstructured":"Sadore, A. A., Gebretsadik, L. A. & Hussen, M. A. Compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha District, South Ethiopia: Community based cross-sectional study. J. Environ. Public Health 2015, 7 (2015).","journal-title":"J. Environ. Public Health"},{"key":"89115_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-020-2835-0","volume":"20","author":"FW Sendeku","year":"2020","unstructured":"Sendeku, F. W., Azeze, G. G. & Fenta, S. L. Adherence to iron-folic acid supplementation among pregnant women in Ethiopia: A systematic review and meta-analysis. BMC Pregn. Childbirth 20, 1\u20139 (2020).","journal-title":"BMC Pregn. Childbirth"},{"key":"89115_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13104-018-3433-3","volume":"11","author":"TM Birhanu","year":"2018","unstructured":"Birhanu, T. M., Birarra, M. K. & Mekonnen, F. A. Compliance to iron and folic acid supplementation in pregnancy, Northwest Ethiopia. BMC Res. Notes 11, 1\u20135 (2018).","journal-title":"BMC Res. Notes"},{"key":"89115_CR15","doi-asserted-by":"publisher","first-page":"462S","DOI":"10.1093\/jn\/130.2.462S","volume":"130","author":"N Zavaleta","year":"2000","unstructured":"Zavaleta, N., Respicio, G. & Garcia, T. Efficacy and acceptability of two iron supplementation schedules in adolescent school girls in Lima, Peru. J. Nutr. 130, 462S-464S (2000).","journal-title":"J. Nutr."},{"key":"89115_CR16","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1177\/156482650802900304","volume":"29","author":"SC Vir","year":"2008","unstructured":"Vir, S. C. et al. Weekly iron and folic acid supplementation with counseling reduces anemia in adolescent girls: A large-scale effectiveness study in Uttar Pradesh, India. Food Nutr. Bull. 29, 186\u2013194 (2008).","journal-title":"Food Nutr. Bull."},{"key":"89115_CR17","first-page":"137","volume":"46","author":"A Sen","year":"2009","unstructured":"Sen, A. & Kanani, S. J. Impact of iron-folic acid supplementation on cognitive abilities of school girls in Vadodara. Indian Pediatr. 46, 137\u2013143 (2009).","journal-title":"Indian Pediatr."},{"key":"89115_CR18","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s13312-012-0129-y","volume":"49","author":"RM Bhoite","year":"2012","unstructured":"Bhoite, R. M. & Iyer, U. M. Effect of deworming vs iron-folic acid supplementation plus deworming on growth, hemoglobin level, and physical work capacity of schoolchildren. Indian Pediatr. 49, 659\u2013661 (2012).","journal-title":"Indian Pediatr."},{"key":"89115_CR19","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/jora.12431","volume":"29","author":"LD Dorn","year":"2019","unstructured":"Dorn, L. D. et al. Conceptualizing puberty as a window of opportunity for impacting health and well-being across the life span. J. Res. Adolesc. 29, 155\u2013176 (2019).","journal-title":"J. Res. Adolesc."},{"key":"89115_CR20","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/cl2.1085","volume":"16","author":"RA Salam","year":"2020","unstructured":"Salam, R. A. et al. Effects of preventive nutrition interventions among adolescents on health and nutritional status in low-and middle-income countries: A systematic review. Campbell Syst. Rev. 16, 1085 (2020).","journal-title":"Campbell Syst. Rev."},{"key":"89115_CR21","doi-asserted-by":"publisher","first-page":"188","DOI":"10.5539\/gjhs.v5n3p188","volume":"5","author":"M Joshi","year":"2013","unstructured":"Joshi, M. & Gumashta, R. Weekly iron folate supplementation in adolescent girls\u2014An effective nutritional measure for the management of iron deficiency anaemia. Glob. J. Health Sci. 5, 188 (2013).","journal-title":"Glob. J. Health Sci."},{"key":"89115_CR22","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1038\/ejcn.2015.215","volume":"70","author":"P Bansal","year":"2016","unstructured":"Bansal, P. et al. Impact of weekly iron folic acid supplementation with and without vitamin B12 on anaemic adolescent girls: A randomised clinical trial. Eur. J. Clin. Nutr. 70, 730\u2013737 (2016).","journal-title":"Eur. J. Clin. Nutr."},{"issue":"1","key":"89115_CR23","doi-asserted-by":"publisher","first-page":"1832824","DOI":"10.1080\/23311932.2020.1832824","volume":"6","author":"HY Halala","year":"2020","unstructured":"Halala, H. Y. et al. Low dietary diversity and its determinants among adolescent girls in Southern Ethiopia. Cogent Food Agric. 6(1), 1832824 (2020).","journal-title":"Cogent Food Agric."},{"key":"89115_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-53836-5","volume":"9","author":"Y Seyoum","year":"2019","unstructured":"Seyoum, Y. et al. Iron deficiency and anemia in adolescent girls consuming predominantly plant-based diets in rural Ethiopia. Sci. Rep. 9, 1\u20136 (2019).","journal-title":"Sci. Rep."},{"key":"89115_CR25","doi-asserted-by":"crossref","unstructured":"Parwati, N.M. Januraga, P., Suarjaya. The effect of school-based program of iron supplementation in preventing and controlling iron deficiency anemia among adolescent girls: Literature reviews. In 4th International Symposium on Health Research (ISHR 2019), Vol. 22, 126\u2013132 (Atlantis Press, 2020).","DOI":"10.2991\/ahsr.k.200215.025"},{"key":"89115_CR26","first-page":"479","volume":"10","author":"N Angadi","year":"2019","unstructured":"Angadi, N. & Balu, P. Effectiveness of weekly iron and folic acid supplementation programme to control anemia among rural adolescent school girls of Davangere, Karnataka. Natl. J. Community Med. 10, 479\u2013482 (2019).","journal-title":"Natl. J. Community Med."},{"key":"89115_CR27","doi-asserted-by":"publisher","first-page":"37","DOI":"10.4103\/0019-557X.200250","volume":"61","author":"M Bairwa","year":"2017","unstructured":"Bairwa, M. et al. Directly observed iron supplementation for control of iron deficiency anemia. Indian J. Public Health 61, 37 (2017).","journal-title":"Indian J. Public Health"},{"key":"89115_CR28","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1507\/endocrj.K08E-180","volume":"56","author":"K Oyama","year":"2009","unstructured":"Oyama, K. et al. Folic acid prevents congenital malformations in the offspring of diabetic mice. Endocr. J. 56, 29\u201337 (2009).","journal-title":"Endocr. J."},{"key":"89115_CR29","doi-asserted-by":"publisher","first-page":"4760","DOI":"10.3390\/nu5114760","volume":"5","author":"AE Czeizel","year":"2013","unstructured":"Czeizel, A. E. et al. Folate deficiency and folic acid supplementation: The prevention of neural-tube defects and congenital heart defects. Nutrients 5, 4760\u20134775 (2013).","journal-title":"Nutrients"},{"key":"89115_CR30","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1080\/15227950591008240","volume":"24","author":"JC Huhta","year":"2009","unstructured":"Huhta, J. C. & Hernandez-Robles, J. A. Homocysteine, folate, and congenital heart defects. Fetal Pediatr. Pathol. 24, 71\u201379 (2009).","journal-title":"Fetal Pediatr. Pathol."},{"key":"89115_CR31","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006896.pub2","author":"ZS Lassi","year":"2013","unstructured":"Lassi, Z. S. et al. Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes. Cochrane Database Syst. https:\/\/doi.org\/10.1002\/14651858.CD006896.pub2 (2013).","journal-title":"Cochrane Database Syst."},{"key":"89115_CR32","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1017\/S1368980017002828","volume":"21","author":"JA Kavle","year":"2018","unstructured":"Kavle, J. A. & Landry, M. Community-based distribution of iron\u2013folic acid supplementation in low-and middle-income countries: A review of evidence and programme implications. Public Health Nutr. 21, 346\u2013354 (2018).","journal-title":"Public Health Nutr."},{"key":"89115_CR33","doi-asserted-by":"publisher","DOI":"10.31899\/pgy8.1040","volume-title":"The Journey of Out-of-School Girls in Ethiopia: Examining Migration, Livelihoods, and HIV","author":"A Erulkar","year":"2017","unstructured":"Erulkar, A., Medhin, G. & Negeri, L. The Journey of Out-of-School Girls in Ethiopia: Examining Migration, Livelihoods, and HIV (Addis Ababa, 2017)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89115-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89115-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89115-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T05:30:02Z","timestamp":1698989402000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-89115-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,6]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["89115"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-89115-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,6]]},"assertion":[{"value":"9 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"9646"}}