Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls
Shah, B.Kumar.; Gupta, P.
Archives of Pediatrics and Adolescent Medicine 156(2): 131-135
2002
ISSN/ISBN: 1072-4710 PMID: 11814373 DOI: 10.1001/archpedi.156.2.131Document Number: 556774
Objective: To compare the effectiveness of weekly vs. daily iron and folic acid supplementation for control of anaemia in adolescent Nepalese girls. Design: Randomized controlled trial. Setting: A Government Girl School in Dharan, Nepal, an urban foothill town that is 305 m above sea level, during March 1998-99. Subjects: Consecutive healthy adolescent girls (n=209; median age: 15 years) were randomized to 3 groups matched for age, anthropometry and personal and sociodemographical characteristics. Of the 209 subjects, 181 completed the trial. Two girls had adverse reactions to treatment and were excluded. Intervention: Group A (n=70) received a 350 mg ferrous sulfate and 1.5 mg folic acid combination once daily for 90 to 100 days. Group B (n=67) received the tablet under supervision once a week for 14 weeks. Group C (n=72) did not receive any drugs. Outcome Variable: Presupplementation and postsupplementation differences in prevalence of anaemia and change in haematocrit. Results: Prevalence of anaemia (defined as haematocrit <36%) declined from 68.6 to 20% in group A, and from 70.1 to 13.4% in group B postsupplementation (P<0.001). In comparison, the prevalence in group C changed little (68.1 to 65.3%, P=0.81). There was a significant rise in the mean haematocrit of both supplemented groups (group A, 32.9+or-3.5 to 41.0+or-5.6%, P<0.001; group B, 33.2+or-3.6 to 40.4+or-4.9%, P<0.001), but no appreciable change in controls was observed (34.2+or-2.9 to 34.1+or-3.3%, P=0.91). Net change in mean haematocrit in both the supplementation groups was comparable (P=0.57). Conclusions: The prevalence of anaemia in adolescent Nepalese girls is high. Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anaemia in adolescent girls.