Title : Efficacy of once a week Vs daily supplementation of 200 mg of ferrous sulphate for control of anaemia in school going menstruating adolescent girls – A stratified individually randomized open label control trial
Background: Anaemia is one of the most common global public health problem among adolescents affecting both, developing and developed countries with major consequences for health as well as socio-economic development. In developing countries the prevalence of anaemia is 43 % whereas, 9 % in developed countries. In view of the several controversial results of various studies, the study on the efficacy of once a week Vs daily supplementation of 200 mg of ferrous sulphate for control of anaemia in school going menstruating adolescent girls .
Purpose Statement: To study the efficacy of once a week Vs. daily oral iron supplementation of 200mg of ferrous sulphate, in terms of increase in haemoglobin levels, in mild and moderate anaemic menstruating adolescent girls.
Hypothesis: Once a week iron supplementation is equally effective to that of daily iron supplementation for control of anaemia in school going menstruating anaemic adolescent girls.
Material and Methods: A stratified individually randomized open label control trial was undertaken on total of 588 menstruating adolescent girls studying in selected eight schools of Handignur PHC. At baseline, structured questionnaire was administered to collect the socio-demographic information, knowledge and practice regarding anaemia and its prevention. Measurement of height and weight was done. All the girls were dewormed and haemoglobin estimation was carried out by cyanmethaemoglobin method. Menstruating adolescent girls who had fulfilled the inclusion criteria were subjected to intervention based on computer generated randomization list into two groups. Group A: Daily supplementation of 200mg of ferrous sulphate (60mg of elemental iron), Group B: Weekly supplementation of 200mg of ferrous sulphate (60mg of elemental iron). Haemoglobin estimation was done at baseline, one, two and three months of iron supplementation to know the improvement in two groups. Data was analysed by SPSS 16.0 version. Intention to treat analysis was carried out. Percentage, mean, median and standard deviations were calculated. Chi-square test, t test, multivariate linear and logistic regressions were applied. P value <0.05 was considered significant.
Results : Prevalence of anaemia in menstruating adolescent girls was 94.6% (95% CI 92.83 to 96.37), of whom 77.89% had moderate anaemia, followed by 12.07% severe and 10.03% mild anaemia. Daily regimen girls reached to normal Hb earlier i.e. 12.5 mg/dl at 75th percentile, however weekly regimen girls reached at 90th percentile.
Conclusion : If all the adolescent girls are provided with the much required iron supplementation till the age of 19 years through AWW’s, school teachers and ANM’s, it will be possible to achieve MDG 4 and 5 for India.