Daily versus weekly iron supplementation and prevention of iron deficiency anaemia in lactating women

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.

Impact of twice weekly versus daily iron supplementation during pregnancy on maternal and fetal haematological indices: a randomized clinical trial

“…The fact that compliance with treatment is related to more important factors than gastrointestinal tract side-effects has been reported by other researchers [5,8]. A lower prevalence of gastrointestinal side-effects were reported by the twice weekly supplemented mothers, which is in line with other studies that reported reducing iron dose or intermittent prescription could decrease these complications [15,18,19] The relationship of maternal anaemia and cord blood iron status has been established in several studies [20]. In the present study, cord blood Hb and ferritin concentrations were not different between the 2 supplemented groups, while maternal ferritin levels were lower in the twice weekly group, confirming the efficiency of twice weekly iron consumption in preventing fetal anaemia and iron deficiency in the absence of maternal hypoferritinaemia.…”

“…Twice weekly iron supplementation has been shown to be effective in the prevention of iron deficiency anaemia in non-pregnant women, children and adolescent girls [2,14,15]. The present study results confirmed that it is also useful during pregnancy in low-risk non-anaemic pregnant women and their newborns.…”

Daily versus intermittent iron supplementation in pregnant women

“…No significant difference was observed between the groups and the authors concluded that weekly supplementation of iron was as effective as daily supplementation in preventing anemia in pregnant women [11]. In the study by Haidar in Ethiopia, weekly iron supplementation was as effective as daily regimen in preventing anemia in breast feeding women [19]. In another study in Mexico by Casanueva and co-workers to compare the daily prescription of 60 mg elemental iron (n = 56) with weekly prescription of 120 mg elemental iron, both regimens were equally effective in preventing anemia in pregnancy.…”

Factors Associated with Anemia among Lactating Mothers in Subsistence Farming Households from Selected Districts of Jimma Zone, South Western Ethiopia: A Community Based Cross-Sectional Study

“…Although the magnitude of iron deficiency anemia, the most common form of nutritional anemia in Ethiopia has not yet been investigated, limited data is available on the prevalence of anemia among pregnant and lactating women in the rural communities, which showed a prevalence rate of 18.7% [19]. In a study conducted in urban slum communities of Addis Ababa, the capital city of Ethiopia, the prevalence rate was 22.3% among lactating women [20].…”