Article

Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants.

Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. ocruz.br
Revista de saude publica (impact factor: 1.01). 08/2008; 42(5):786-95. pp.786-95
Source: PubMed

ABSTRACT To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants.
Randomized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro, Brazil, between 2004 and 2005. Three concurrent cohorts were compared: daily group (n=150; 12.5mg Fe/day); weekly group (n=147; 25mg Fe/week) and control group. The intervention consisted of universal supplementation with iron sulfate for 24 weeks, combined with educational adherence-promoting measures. Outcome: mean serum hemoglobin concentration, distribution and prevalence of anemia (Hb<110.0 g/l) at age 12 months. Effectiveness was evaluated considering both intent to treat and adherence to protocol, using multiple regression analysis (linear and Poisson).
Groups were homogeneous in terms of descriptive variables. The intervention was implemented successfully, with high adhesion to protocol in both groups, and no statistical difference between them. After adjustment, only the daily regimen showed a protective effect. Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen. No protective effect was detected for the weekly regimen.
Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis.

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Keywords

adherence
 
Adherence analysis
 
age 12 months
 
concurrent cohorts
 
control group
 
descriptive variables
 
educational adherence-promoting measures
 
evident dose-response effect
 
iron sulfate
 
multiple regression analysis
 
primary health care units
 
protective effect
 
Randomized clinical field trial
 
Rio de Janeiro
 
serum hemoglobin concentration
 
universal prophylactic
 
universal supplementation
 
weekly basis
 
weekly group
 
weekly regimen