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DAILY VERSUS WEEKLY IRON SUPPLEMENTATION AND PREVENTION OF IRON DEFICIENCY ANAEMIA IN LACTATING WOMEN
Abstract
ABSTRACT
Objective: To demonstrate the effectiveness and social feasibility of weekly versus daily iron
supplementation in preventing and treating iron deficiency anaemia among anaemic
mothers.
Design: A longitudinal in nature.
Setting: Seven urban slum communities in Teklehaimanot Wereda, Addis Ababa, Ethiopia.
Subjects: Two hundred seven eligible mothers were assigned to the daily supplementation,
weekly supplementation or control groups following randomisation between March and
May 2001. The daily supplemented groups (n=71) received 60 mg of elemental iron
containing 300 mg ferrous sulphate and 400 μg folic acid from monday to friday. The weekly
group (n=68) received one tablet once a week every monday supervised while the control
group (n=68) was advised to take no medications without the knowledge of the investigators
until the completion of the study. To eliminate a major source of variation, subjects
participating in the study were de-wormed at the beginning of the study.
Main outcome measures: Haemoglobin and serum ferritin concentrations were compared
before and after the intervention among the groups.
Results: The mean haemoglobin (Hgb), and serum ferritin concentration (SFC) at baseline
were practically similar among the groups. Haemoglobin levels significantly increased at
the end of the study in all the groups and the proportion of anaemia decreased from 6.9%
to 1.6% in the daily, 6.7% to 1.7% in the weekly supplemented and 6.7% to 6.1% in the
control groups. The difference noted between the daily and weekly supplemented groups
was not significant. The improvement of SFC concentration was better in the daily than the
weekly group but not statistically significant. Daily supplementation schedule caused more
side effects and lower compliance level than the weekly supplementation schedule.
Conclusion: Weekly supplementation is simple, comparable to daily supplementation and
economically advantageous. Thus, it is recommended to adopt the strategy for controlling
anaemia. Further because of higher compliance rate and lower side effects, it is deemed to
be socially feasible.
Objective: To demonstrate the effectiveness and social feasibility of weekly versus daily iron
supplementation in preventing and treating iron deficiency anaemia among anaemic
mothers.
Design: A longitudinal in nature.
Setting: Seven urban slum communities in Teklehaimanot Wereda, Addis Ababa, Ethiopia.
Subjects: Two hundred seven eligible mothers were assigned to the daily supplementation,
weekly supplementation or control groups following randomisation between March and
May 2001. The daily supplemented groups (n=71) received 60 mg of elemental iron
containing 300 mg ferrous sulphate and 400 μg folic acid from monday to friday. The weekly
group (n=68) received one tablet once a week every monday supervised while the control
group (n=68) was advised to take no medications without the knowledge of the investigators
until the completion of the study. To eliminate a major source of variation, subjects
participating in the study were de-wormed at the beginning of the study.
Main outcome measures: Haemoglobin and serum ferritin concentrations were compared
before and after the intervention among the groups.
Results: The mean haemoglobin (Hgb), and serum ferritin concentration (SFC) at baseline
were practically similar among the groups. Haemoglobin levels significantly increased at
the end of the study in all the groups and the proportion of anaemia decreased from 6.9%
to 1.6% in the daily, 6.7% to 1.7% in the weekly supplemented and 6.7% to 6.1% in the
control groups. The difference noted between the daily and weekly supplemented groups
was not significant. The improvement of SFC concentration was better in the daily than the
weekly group but not statistically significant. Daily supplementation schedule caused more
side effects and lower compliance level than the weekly supplementation schedule.
Conclusion: Weekly supplementation is simple, comparable to daily supplementation and
economically advantageous. Thus, it is recommended to adopt the strategy for controlling
anaemia. Further because of higher compliance rate and lower side effects, it is deemed to
be socially feasible.
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