Joshi Mohan, Gumashta Raghvendra
NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India.
Glob J Health Sci. 2013 Mar 20;5(3):188-94. doi: 10.5539/gjhs.v5n3p188.
Nutritional anaemia in India is common morbidity seen in late adolescent and young female population. There are many conflicting opinions regarding dosage of iron folic acid supplementation for managing this simple nutritional deficiency disorder. Hence, this 'Randomized Controlled Trial' was undertaken in adolescent girls suffering from Iron Deficiency Anaemia visiting 'Urban Health and Training Centre' situated in urban slum area. The aim of this study was to assess the (a) Impact of weekly iron folic acid supplementation in comparison with daily iron supplementation for the management of Iron Deficiency Anaemia in adolescent girls visiting 'Urban Health and Training Centre'; (b) Adverse drug reaction profile in 'Weekly Iron Folic Acid Supplementation' and 'Daily Iron Folic Acid Supplementation' regimes; (c) Compliance profile for 'Weekly Iron Folic Acid Supplementation' and 'Daily Iron Folic Acid Supplementation' regimes in adolescent girls.
Randomized controlled trial was conducted in adolescent girls visiting 'Urban Health and Training Centre' during the study period June, 2011 to October, 2012. The 120 anaemic (Haemoglobin < 12 gm%) adolescent girls (10-19 years) were distributed randomly by block randomization in two groups; one receiving daily Iron and Folic Acid supplementation and in other group receiving weekly Iron and Folic Acid supplementation for 3 months. All the study subjects were given de-worming (Albendazole 400 mg) and required health education separately. Both the groups were monitored for Haemoglobin estimation, compliance and adverse drug reactions, if any. Open-Epi Statistical Software was used for data analysis.
The mean age of study subjects in 'Daily Iron and Folic Acid Supplementation' and 'Weekly Iron and Folic Acid Supplementation' group was 13.48 and 13.55 years respectively. Their mean pre intervention Haemoglobin was 10.1±1.1 gm/dl and 10.4±1.1 gm/dl respectively. The mean rise in Haemoglobin after lean period of 1 month in respective groups was almost equal i.e. 1.0±0.7 gm/dl and 1.0±0.8 gm/dl. Adverse Drug Reactions were 8.3% in weekly regime as compared to 13.35% in daily regime, abdominal pain being the commonest adverse drug reaction seen .The compliance calculated as mean of unconsumed 'Iron and Folic Acid' tablets was 6.1±10.98 in 'Daily Iron Folic Acid Supplementation' group, while it was 1.3±3.15 in 'Weekly Iron Folic Acid Supplementation' group (p=0.0012), making weekly regime more promising than daily regime with better treatment compliance.
Weekly supplementation of 'Iron and Folic Acid' in 'Iron Deficiency Anaemia' patients is as good as daily supplementation with added benefits of less adverse reactions and better compliance.
营养性贫血在印度是青少年晚期和年轻女性群体中常见的发病情况。关于补充铁叶酸以治疗这种简单的营养缺乏症的剂量，存在许多相互矛盾的观点。因此，这项“随机对照试验”在患有缺铁性贫血的青少年女孩中进行，她们前往位于城市贫民窟地区的“城市健康与培训中心”就诊。本研究的目的是评估：(a) 与每日补充铁剂相比，每周补充铁叶酸对前往“城市健康与培训中心”就诊的青少年女孩缺铁性贫血的治疗效果；(b) “每周补充铁叶酸”和“每日补充铁叶酸”方案中的药物不良反应情况；(c) 青少年女孩对“每周补充铁叶酸”和“每日补充铁叶酸”方案的依从性情况。
在2011年6月至2012年10月的研究期间，对前往“城市健康与培训中心”就诊的青少年女孩进行了随机对照试验。120名贫血（血红蛋白<12克%）的青少年女孩（10 - 19岁）通过区组随机化被随机分为两组；一组每日补充铁和叶酸，另一组每周补充铁和叶酸，为期3个月。所有研究对象均分别接受驱虫治疗（阿苯达唑400毫克）并接受所需的健康教育。对两组均进行血红蛋白测定、依从性及药物不良反应（如有）的监测。使用Open - Epi统计软件进行数据分析。
“每日补充铁叶酸”组和“每周补充铁叶酸”组研究对象的平均年龄分别为13.48岁和13.55岁。她们干预前的平均血红蛋白分别为10.1±1.1克/分升和10.4±1.1克/分升。在各自组中经过1个月的治疗期后，血红蛋白的平均升高幅度几乎相同，即1.0±0.7克/分升和1.0±0.8克/分升。每周方案的药物不良反应发生率为8.3%，而每日方案为13.35%，腹痛是最常见的药物不良反应。以未服用的“铁和叶酸”片剂的平均值计算，“每日补充铁叶酸”组的依从性为6.1±10.98，而“每周补充铁叶酸”组为1.3±3.15（p = 0.0012），这使得每周方案比每日方案更具优势，治疗依从性更好。
在缺铁性贫血患者中，每周补充“铁和叶酸”与每日补充效果相当，且具有不良反应更少和依从性更好的额外益处。
