Felix Flemin, Karun Kalesh Mappilakudy, Nagendraswamy Chandan, Sadanandan Deepthy Melepurakkal, Damodaran Yadu, Barvaliya Manish, Roy Subarna
Department of Health Systems Research, ICMR - National Institute of Traditional Medicine, Nehru Nagar, Belagavi, 590010, Karnataka, India.
Women's and Children's Health Research Unit, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, 590010, Karnataka, India.
J Res Health Sci. 2025 Jun 10;25(3):e00651. doi: 10.34172/jrhs.8985.
The prevalence of iron-deficiency anemia (IDA) among school-aged children in India varies from 27% to 90%. There is no evidence of the comparative effects of various available interventions. Thus, this study aimed to quantify and rank the effects of different interventions on IDA among school-going children. Systematic review and Meta-analysis.
To this end, PubMed, Scopus, and ScienceDirect databases were searched, and randomized controlled trials (RCTs) evaluating the comparative effects of various interventions on hemoglobin (Hb) and serum ferritin against a control were included in this study. The random-effect model was conducted for Hb, and the fixed-effects model was performed for ferritin to estimate the mean difference (MD) and 95% confidence interval (CI) of the effect of interventions of outcomes based on the heterogeneity (I ).
Eight RCTs (including 2534 participants) investigating the effects of 12 interventions for IDA treatment among school-going children in India were obtained. The results of reference-based forest plots and score indicated that iron-rich fish powder was the most effective intervention for increasing Hb levels (MD: 2.07 g/dL, 95% CI: 0.68-3.47, score=0.8656), followed by iron and folic acid (IFA) given twice weekly (MD: 1.47 g/dL, 95% CI: -0.31-3.25, score=0.7209). Additionally, IFA supplementation twice weekly was found to be highly effective in increasing serum ferritin levels among anemic school children (MD: 0.80 ng/mL, 95% CI: 0.33-1.27, score=0.9148).
It seems that iron-rich fish powder and intermittent IFA supplementation were the most effective interventions, but further research is needed to confirm these results and assess their public health implications. PROSPERO registration number was CRD42024541802.
印度学龄儿童缺铁性贫血（IDA）的患病率在27%至90%之间。目前尚无证据表明各种现有干预措施的比较效果。因此，本研究旨在量化并排序不同干预措施对学龄儿童缺铁性贫血的影响。系统评价和Meta分析。
为此，检索了PubMed、Scopus和ScienceDirect数据库，本研究纳入了评估各种干预措施对血红蛋白（Hb）和血清铁蛋白的比较效果并设对照组的随机对照试验（RCT）。对Hb采用随机效应模型，对铁蛋白采用固定效应模型，以根据异质性（I²）估计干预措施对结局影响的平均差（MD）和95%置信区间（CI）。
获得了八项RCT（包括2534名参与者），这些研究调查了印度学龄儿童12种缺铁性贫血治疗干预措施的效果。基于参考文献的森林图和I²评分结果表明，富铁鱼粉是提高Hb水平最有效的干预措施（MD：2.07 g/dL，95% CI：0.68 - 3.47，I²评分 = 0.8656），其次是每周两次给予铁和叶酸（IFA）（MD：1.47 g/dL，95% CI： - 0.31 - 3.25，I²评分 = 0.7209）。此外，发现每周两次补充IFA在提高贫血学龄儿童血清铁蛋白水平方面非常有效（MD：0.80 ng/mL，95% CI：0.33 - 1.27，I²评分 = 0.9148）。
富铁鱼粉和间歇性补充IFA似乎是最有效的干预措施，但需要进一步研究来证实这些结果并评估其对公共卫生的影响。PROSPERO注册号为CRD42024541802。
