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Medline ® Abstract for Reference 50

of 'Iron requirements and iron deficiency in adolescents'

Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls.
Shah BK, Gupta P
Arch Pediatr Adolesc Med. 2002;156(2):131.
OBJECTIVE: To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia 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.
SUBJECTS: Consecutive healthy adolescent girls (n = 209, median age 15 years) randomized to 3 groups matched for age, anthropometry, and personal and sociodemographic characteristics. Of 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 anemia and change in hematocrit.
RESULTS: Prevalence of anemia (defined as hematocrit<36%) declined from 68.6% and 70.1% in groups A and B to 20% and 13.4%, respectively, postsupplementation (P<.001), whereas the prevalence in group C changed little (68.1% to 65.3%, P =.81). There was a significant rise in the mean hematocrit of both supplemented groups (group A, 32.9% +/- 3.5% to 41.0% +/- 5.6%, P<.001; group B, 33.2% +/- 3.6% to 40.4% +/- 4.9%, P<.001) but no appreciable change in controls (34.2% +/- 2.9% to 34.1% +/- 3.3%, P =.91). Net change in mean hematocrit in both the supplementation groups was comparable (P =.57).
CONCLUSIONS: The prevalence of anemia 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 anemia in adolescent girls.
Department of Pediatrics, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.