Effective community intervention to improve hemoglobin status in preschoolers receiving once-weekly iron supplementation. Effect of daily vs twice weekly iron supplementation in Indonesian preschool children with low iron status. Once weekly is superior to daily iron supplementation on height gain but not on hematological improvement among schoolchildren in Thailand. [Efficacy of daily and weekly iron supplementation for the control of iron deficiency anaemia in infants in rural Vietnam]. [Effect of daily or once weekly iron supplementation on growth and iron status of preschool children]. Weekly iron supplementation is as effective as 5 day per week iron supplementation in Bolivian school children living at high altitude. Daily iron supplementation is more efficacious than twice weekly iron supplementation for the treatment of childhood anemia in western Kenya. The effect of different anthelmintic treatment regimens combined with iron supplementation on the nutritional status of schoolchildren in KwaZulu-Natal, South Africa: a randomized controlled trial. Weekly iron supplements given by teachers sustain the haemoglobin concentration of schoolchildren in the Philippines. Growth in non-anemic infants supplemented with different prophylactic iron doses. Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children. Simultaneous weekly supplementation of iron and zinc is associated with lower morbidity due to diarrhea and acute lower respiratory infection in Bangladeshi infants. School-administered weekly iron supplementation--effect on the growth and hemoglobin status of non-anemic Bolivian school-age children. A randomized placebo-controlled trial. Effects of three different iron supplementations in term healthy infants after 5 months of life. Intermittent administration of iron and sulfadoxine-pyrimethamine to control anaemia in Kenyan children: a randomised controlled trial. Effectiveness of biweekly versus daily iron-folic acid administration on anaemia status in preschool children. Comparison of the effectiveness of weekly and daily iron supplementation in 6- to 24-months-old babies in urban health centers of Sari, Iran. Efficacy of daily and weekly iron supplementation on iron status in exclusively breast-fed infants. Effectiveness of intermittent iron treatment of two- to six-year-old Jordanian children with iron-deficiency anemia. Micronutrient and iron supplementation and effective antimalarial treatment synergistically improve childhood anaemia. Physical work capacity of young underprivileged school girls impact of daily vs intermittent iron folic acid supplementation: a randomized controlled trial. The impact of iron supplementation on reinfection with intestinal helminths and Schistosoma mansoni in western Kenya. A randomised trial in Mali of the effectiveness of weekly iron supplements given by teachers on the haemoglobin concentrations of schoolchildren. Effect of twice weekly versus daily iron treatment in Turkish children with iron deficiency anemia. The effectiveness of weekly iron and vitamin supplementation of Malawian preschool children. Preventive strategy to control iron deficiency anemia in children and adults. Daily and weekly iron supplementation and physical growth of school age Indonesian children. Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants.
The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked, placebo-controlled field trial. Subjects were 289 preschoolers who were randomly divided into three groups. Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo. Group 1 additionally received anthelminthic treatment. Supplements were administered by the mothers, who were educated about iron deficiency beforehand. In the iron-supplemented groups prevalence of anemia decreased from 37.2% to 16.2% (P < 0.001). Hemoglobin increased by an average of 6.9 +/- 9.8 g/L in the two iron-supplemented groups (n = 191), which was greater (P < 0.001) than the increase of 1.9 +/- 8.0 g/L in the placebo group. None of the subjects had hookworm, and anthelminthic treatment did not have an additional effect. Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff. The effect of daily vs twice weekly iron supplementation on iron status was studied in preschool children with low iron status in a randomized double-masked field trial. Subjects (n = 87) were selected on the basis of their hemoglobin concentration being < 111 g/L in finger-prick blood, and were divided into two groups. For 8 wk one group received a daily supplement of 30 mg Fe, while the other group received 30 mg Fe twice per week. A complete data set was obtained from 32 children in the group supplemented daily and from 33 children in the group supplemented twice weekly. Hemoglobin, serum ferritin, and protoporphyrin increased significantly in both groups (P < 0.001). Changes in hemoglobin and protoporphyrin were correlated with initial hemoglobin concentration (P < 0.001). The difference in treatment effect between groups was not significant after correction for the initial hemoglobin concentration. It is concluded that in preschool children with low iron status, twice weekly iron supplementation has an effect on iron status similar to that of daily supplementation. Intermittent iron supplementation has been suggested as a replacement for daily iron supplements for reducing anemia in developing countries. The effects of once weekly and daily iron supplementation on hemoglobin (Hb), serum ferritin (SF), prevalence of anemia, weight and height are compared in this study. Primary schoolchildren (n = 397) from two selected schools in the Hat Yai rural area, southern Thailand, were recruited in 1999. All children received Albendazole and then randomly received ferrous sulfate (300 mg/tablet) either daily or weekly, or a placebo for 16 wk. The average increase in Hb was not significantly different between the daily (mean +/- SD; 6.5 +/- 6.0 g/L) and weekly (5.7 +/- 6.3 g/L) groups. However, the average increase in SF was greater (P < 0.01) in the daily (mean +/- SD; 39.8 +/- 30.3 microg/L) than the weekly (13.4 +/- 17.3 microg/L) group. All cases of iron deficiency anemia were abolished in both daily and weekly groups, whereas no reduction in prevalence occurred in the placebo group. Height gain was greater in children who received weekly (mean +/- SD; 2.6 +/- 0.9 cm) than in those who received daily iron (mean +/- SD; 2.3 +/- 0.8 cm), (P < 0.01). Weight gain, weight-for-age and height-for-age were not significantly different among the intervention groups. It is concluded that a weekly iron dose is more effective than a daily dose in height gain but not in hematological improvement over 16 wk of supplementation. In Vietnam the high prevalence of iron deficiency anaemia in infants and young children speaks for implementing early interventions. This study aimed to evaluate the efficacy of the daily iron supplementation in infants given by their mothers and of the weekly iron supplementation. Two hundred and seventy infants aged 5 to 12 months, were divided into four groups. Group 1 received a placebo daily and group 2 a daily dose of 15 mg iron (2.0 +/- 0.3 mg iron/day/kg body weight) which was given by their mothers for three months. Group 3 received a daily dose of 15 mg iron and group 4 a weekly dose of 15 mg iron given during 6 months by health auxiliaries. The hemoglobin concentration (Hb) was measured before the intervention and after 3 months of supplementation in all groups, and again after 6 months of supplementation in groups 3 and 4. After 3 months of iron supplementation, the hemoglobin concentration increased significantly by 21.6 +/- 12.3 g/l and the prevalence of anaemia decreased from 81.3% to less than 9% in group 2. The weekly iron supplementation was significantly less effective than the daily supplementation: after 3 months, Hb increased by 15.4 +/- 13.3 g/l in group 3 and by 11.2 +/- 10.2 g/l in group 4 (p = 0.04) and the prevalence of anaemia was 17.9% and 41.5% in groups 3 and 4, respectively. After 6 months of supplementation, changes in Hb were not significantly different between group 3 (22.0 +/- 12.1 g/l) and group 4 (20.0 +/- 10.0 g/l, p = 0.30). However, the final hemoglobin concentration was significantly lower in group 4 (120.5 +/- 7.2 g/l) than in group 3 (123.6 +/- 7.8, p = 0.02). Moreover, nearly 8% of the children were still anemic in group 4 versus 0% in group 3. Since the early developmental period, when the brain and other specific organs are especially sensitive to iron deficiency, is critical, 3-month daily iron supplementation of infants from the age of 6 months has to be recommended, followed by a weekly iron supplementation until the age of 15 months. The community approach, where mothers informed on the importance of iron deficiency anaemia and on the consequences for the health of their infants gave the iron supplements, was shown to be effective. However, its sustainability would depend on the availability of low-cost iron supplements affordable by populations with limited economic resources. Other interventions, such as iron supplementation of women during fertile age, especially during pregnancy and lactation periods, and the use of complementary food to breast milk, fortified with micronutrients, should be associated. The effect of daily and once weekly iron supplementation on hemoglobin(Hb), serum ferritin (SF), erythrocyte protoporphyrin (EFP) in whole blood, prevalence of iron deficiency, body weight and height of preschool children was compared in this study.
                Preschool children (n = 353) from one kindergarten in Baotou City, was recruited. All children were divided into three groups by class, and received either daily or once weekly iron supplementation, or a placebo (control) for 14 weeks.
                The prevalence of iron deficiency was reduced in both intervention groups, and the rate in the group supplemented with iron once weekly was significantly lower than that of the control group(P < 0.05). The levels of Hb, SF, increased after once weekly and daily iron supplementation. Weight gain and WAZ were greater in children who received daily supplement than in those who received placebo. Height gain and HAZ were not significantly different among three groups.
                Daily micronutrient supplement can improve growth of preschool children. Once weekly iron supplement is effective same as daily supplement in improving iron status and reducing the prevalence of iron deficiency in the preschool children. To compare the efficacy of a daily and a weekly iron supplementation on the hematological status of anemic children living at high altitude.
                Double blind iron supplementation trial including a placebo control group.
                A socioeconomically disadvantaged district of La Paz, Bolivia (altitude of 4000 m).
                Anemic (hemoglobin concentration < or = 144 g/L), 3.3-8.3 y old children of both sexes.
                Children received a placebo (n = 57) or a dose of 3-4 mg of elemental iron per kg body weight (FeSO4 tablets) 1 d per week (n = 58) or 5 d per week (n = 58) for 16 weeks.
                Hemoglobin and zinc erythrocyte protoporphyrin concentrations improved significantly in supplemented groups but not in the placebo group. Changes in hemoglobin during the study were not significantly different between supplemented groups (weekly group: 15.2 +/- 6.9 g/L and daily group: 18.6 +/- 11.1 g/L) but were different from the placebo group (0.5 +/- 7.1 g/L, P < 0.001). At the end of the supplementation period, the hemoglobin distribution was Gaussian, and similar in both supplemented groups. Adjusting for the initial hemoglobin concentration, final hemoglobin and its changes were similar in both supplemented groups.
                Weekly iron supplementation is as efficacious as daily iron supplementation in improving iron status and correcting moderate iron deficiency anemia in Bolivian school children living at high altitude.
                Program supported in part by ORSTROM, the French Ministry of Foreign Affairs and the National Secretary's Office of Health, Bolivia. A recent meta-analysis of 14 clinical trials indicated that daily compared with intermittent iron supplementation resulted in significantly greater hematological improvement in pregnant women. No such definitive beneficial effect was demonstrated in preschool children. We compared the efficacy of daily and twice weekly iron supplementation for 6 wk under supervised and unsupervised conditions in the treatment of mild and moderate anemia [hemoglobin (Hb) 50-109 g/L] in children aged 2-59 mo living in a malaria-endemic area of western Kenya. The study was a cluster-randomized trial using a factorial design; participants were aware of the treatment assigned. All children (n = 1049) were administered a single dose of sulfadoxine-pyrimethamine at enrollment followed by 6 wk of daily supervised iron supplementation [3-6 mg/(kg.d)], twice weekly supervised iron supplementation [6-12 mg/(kg.wk)], daily unsupervised iron supplementation, or twice weekly unsupervised iron supplementation. In the supervised groups, Hb concentrations at 6 and 12 wk (6 wk postsupplementation) were significantly higher in children given iron daily rather than twice weekly [mean (95% CI) difference at 6-wk: 4.2 g/L (2.1, 6.4); 12-wk: 4.4 g/L (1.8, 7.0)]. Among the unsupervised groups, Hb concentrations were not different at 6 wk [mean (95% CI) difference: 0.86 g/L (-1.4, 3.1)], but significantly higher at 12 wk for those assigned daily iron [mean (95% CI) difference: 3.4 g/L (0.79, 6.0), P = 0.02]. In this malarious area and after initial antimalarial treatment, 6 wk of daily iron supplementation results in better hematological responses than twice weekly iron supplementation in the treatment of anemia in preschool children, regardless of whether adherence can be ensured. A randomized controlled trial in KwaZulu-Natal (South Africa) of 428 primary-school pupils (stratified into 6 groups by age, sex and intervention) measured the effect of different anthelmintic treatments and iron supplementation regimens provided twice at 6-monthly intervals for 1 year (1996/97). Half the pupils received iron supplementation (ferrous fumarate 200 mg weekly for 10 weeks). Pupils received 2 anthelmintic regimens, either (i) albendazole 400 mg plus praziquantel 40 mg/kg or (ii) albendazole 400 mg on 3 consecutive days plus praziquantel 40 mg/kg or (iii) placebo. Baseline prevalences of Ascaris 55.9%, Trichuris 83.6%, hookworm spp. 59.4%, were reduced after 12 months for single-dose albendazole treatment to Ascaris 17.4% (P < 0.005), Trichuris 61.5% (NS), hookworm spp. 0% (P < 0.005), and for triple-dose albendazole treatment to Ascaris 14.8% (P < 0.005), Trichuris 25.0% (P < 0.01), hookworm 0% (P < 0.005). Schistosoma haematobium 43.4% was reduced among treated groups to 8.3% (P < 0.005). There were no significant changes in the anthropometry of the different treatment groups at either 6 or 12 months post treatment. Twelve months after treatment there was a significant increase in haemoglobin levels (P = 0.02) among pupils receiving triple-dose albendazole, praziquantel and ferrous fumarate; pupils receiving no anthelmintic treatment showed a significant decrease as did pupils who received triple-dose albendazole and praziquantel but no iron. Regular 6-monthly anthelmintic treatment significantly reduced the prevalence of Ascaris, hookworm spp. and S. haematobium infections (P < 0.05). Triple-dose treatment for Trichuris was significantly more effective than a single dose of albendazole 400 mg (P = 0.002). In areas with schistosomiasis, hookworm infection and high prevalence of Trichuris infection, combination treatment with praziquantel, triple-dose albendazole, plus iron supplementation, is likely to improve pupils' health and haemoglobin levels. To examine the effectiveness of weekly iron supplements given for 10 weeks by teachers to children in rural schools in the Philippines.
                Forty-nine rural primary schools took part in the study and were randomly assigned to two groups: children in 25 schools received a weekly tablet providing 108 mg iron while children in 24 schools acted as controls. All children were dewormed before the start of the iron supplementation. The haemoglobin concentration of a systematic sample of one in three children in two classes in each school was estimated before and 5-17 weeks after the end of the iron supplementation.
                A total of 1510 children aged 7-12 years were studied at both surveys. The mean haemoglobin concentration of children in the intervention group did not change significantly; in the untreated group it fell by 3.8 g/l and the prevalence of anaemia rose from 14.3% to 25.6%. The difference between study groups was significantly larger amongst the younger children (7-8 years), and was observed in both anaemic and non-anaemic children.
                Even where anaemia is only a mild public health problem, weekly iron supplements given by teachers may prevent a fall in the haemoglobin concentration, and can benefit both anaemic and non-anaemic children. To compare the effects of different prophylactic iron doses on the growth and nutritional status of non-anemic infants.
                Prospective randomized study. Infants aged 5.0 to 6.9 months who met the inclusion criteria and showed capillary hemoglobin >or= 11 g/dL were randomly allocated into three groups who received the following prophylactic doses of iron supplement (ferrous sulfate): 1 mg/kg/day (n = 39); 2 mg/kg/day (n = 36); and 25 mg/week (n = 39). This supplementation was given during 16 weeks. Both weight and length were measured. The nutritional status was evaluated by comparing z scores for weight/age, length/age and weight/length based on the World Health Organization (2006) references. Morbidity information was collected during monthly visits.
                The groups showed similar nutritional status before supplementation. There were no differences in daily nutrient intake among groups. During the study, weight and length gain, and increments in anthropometric indices did not differ statistically among supplemented groups. The occurrence and duration of morbidity episodes did not differ statistically among groups. In general, improvements were observed in both weight/age and weight/length indices in the population under study, whereas length/age showed no differences before and after supplementation.
                Different prophylactic iron doses had no different effects on the growth and nutritional status of non-anemic infants. Micronutrient deficiencies remain common in preschool children in developing countries. Interventions focus on single micronutrients and often lack effectiveness. Weekly instead of daily supplementation may improve effectiveness.
                The efficacy of weekly and daily supplementation in reducing anemia prevalence and in improving the zinc, vitamin A, and growth status of 6-24-mo-old Vietnamese children was investigated.
                In this double-blind, placebo-controlled trial, the daily group (n = 55) received 8 mg elemental Fe (as iron sulfate), 5 mg elemental Zn (as zinc sulfate), 333 microg retinol, and 20 mg vitamin C 5 d/wk for 3 mo. The weekly group (n = 54) received 20 mg Fe, 17 mg Zn, 1700 microg retinol, and 20 mg vitamin C once a week. A third group (n = 54) received a placebo only. Venous blood samples were collected at the start and end of the supplementation period and anthropometric measurements were taken at the start and 3 mo after the end of supplementation.
                At baseline, 45.6% of subjects had hemoglobin concentrations < 110 g/L, 36.3% had zinc concentrations < 10.71 micromol/L, and 45.6% had retinol concentrations <0.70 micromol/L. Hemoglobin, retinol, and zinc concentrations of both the weekly and daily groups increased similarly compared with the placebo group (P < 0.001). There was no significant difference in growth between the supplemented groups and the placebo group. However, the height-for-age of subjects stunted at baseline increased with z scores of 0.48 (P < 0.001) and 0.37 (P < 0.001) for the daily and weekly groups, respectively.
                Weekly and daily supplementation improved hemoglobin, zinc, and retinol concentrations similarly. Neither intervention affected growth of the overall population, but growth of children stunted at baseline was improved through both types of supplementation. Given the high prevalence of micronutrient deficiencies and infectious diseases in infants in developing countries, an evaluation of the efficacy of different micronutrient formulations on infant morbidity is a priority. The efficacy of weekly supplementation of four different micronutrient formulations on diarrhea and acute lower respiratory infection (ALRI) morbidity was evaluated in Bangladeshi infants. In a double-blind, randomized, controlled community trial, 799 infants aged 6 mo were randomly assigned to one of the following 5 groups: 1) 20 mg elemental iron with 1 mg riboflavin, 2) 20 mg elemental zinc with 1 mg riboflavin, 3) 20 mg iron and 20 mg zinc with 1 mg riboflavin, 4) a micronutrient mix (MM) containing 20 mg iron, 20 mg zinc, 1 mg riboflavin along with other minerals and vitamins and 5) a control treatment, 1 mg riboflavin only. Health workers visited each infant weekly until age 12 mo to feed the supplement and to collect data on diarrhea and ALRI morbidity. Hemoglobin, serum ferritin and serum zinc levels of a sample of infants were measured at 6 and 12 mo. Compared with the control group, at 12 mo, serum ferritin levels were higher in the iron + zinc group, and serum zinc levels were higher in the zinc and iron + zinc groups. Simultaneous supplementation with iron + zinc was associated with lower risk of severe diarrhea, 19% lower in all infants and 30% lower in less well-nourished infants with weight-for-age Z-score below -1. Iron + zinc supplementation was also associated with 40% lower risk of severe ALRI in less well-nourished infants. MM supplementation was associated with a 15% higher risk of diarrhea in all infants and 22% higher risk in less well-nourished infants. Intermittent simultaneous supplementation with iron + zinc seems promising; it will be useful to determine whether higher doses would provide greater benefits. Recent data suggest that daily iron supplementation of iron-replete children could impair their growth. If verified for weekly iron supplementation these results would markedly complicate targeting and implementing school-based weekly iron supplementation programs.
                To ascertain the effect of weekly iron supplementation on the growth and hemoglobin status of non-anemic school-age children.
                73 Bolivian non-anemic school-age children randomly assigned to the treatment group (n = 37; receiving supplements containing FeSO4 during 18 weeks) or the control group (n = 36; receiving a placebo during the same period). Hemoglobin concentration and anthropometric measures were determined for each child at the beginning (T0) and the end (T18) of the study.
                The treatment group did not show any significant variation in hemoglobin concentration between T0 and T18 (-1.6 +/- 10.4 g/L; P = 0.40) whereas the control group showed a significant decrease in hemoglobin concentration (-4.6 +/- 10.9 g/L; P = 0.03). Anthropometric changes were not significantly different between the treatment and the control groups for weight, (1.63 +/- 1.11 kg vs 1.88 +/- 0.79 kg; P = 0.30), height (2.35 +/- 0.94 cm vs 2.11 +/- 1.03 cm; P = 0.34) or mid-upper arm circumference (0.29 +/- 0.57 cm vs 0.22 +/- 0.54 cm; P = 0.64).
                In our study, weekly iron supplementation of non-anemic school-age children had no negative effect on their growth while having a positive effect in preventing significant decreases in hemoglobin concentration. These results suggest that in regions where iron deficiency anemia (IDA) is prevalent, a simple and cost-effective way to control IDA in school-age children is to give weekly iron supplements to all children at school. The aim of this study was to investigate the effects of different doses of iron on haematological status of breastfed infants. One hundred and thirteen infants were randomized into four groups at 5 months of age. Iron supplementation was given at doses of 1 mg/kg/day, 2 mg/kg/day, and 2 mg/kg/every other day in the first three study groups, respectively, and the last group received placebo. The hematological values, except hemoglobin, were higher in the group supplemented with iron at a dose of 2 mg/kg/day, and ferritin values were statistically higher in the group supplemented with iron at a dose of 2 mg/kg/every other day than in the group supplemented with iron at a dose of 1 mg/kg/day. We suggest that intermittent iron supplementation is more effective than a daily regimen in equal dosages. Iron supplementation is recommended for children at high risk of anaemia, but its benefits may not outweigh the associated risk of malaria in areas of seasonal transmission. We investigated the effect on haemoglobin concentrations of intermittent administration of iron supplements and sulfadoxine-pyrimethamine in symptom-free children under intense health surveillance.
                In a trial of two by two factorial design, 328 anaemic Kenyan children were randomly assigned either iron or placebo and sulfadoxine-pyrimethamine or placebo (82 to each group). Primary outcomes were haemological indicators of iron status and inflammation at the end of the follow-up, and occurrence of malaria attacks. Morbidity surveillance consisted of medical examinations every 4 weeks, continuous passive case detection, and visits twice a week to community health-workers. Analyses were by intention to treat.
                After 12 weeks, the groups assigned iron plus sulfadoxine-pyrimethamine, iron alone, or sulfadoxine-pyrimethamine alone had higher haemoglobin concentrations than the group assigned placebo (treatment effect adjusted for prognostic factors at baseline: 11.1 g/L [95% CI 7.5 to 14.7]; 10.7 g/L [7.1 to 14.3]; and 3.1 g/L [-0.5 to 6.7]). Administration of iron plus sulfadoxine-pyrimethamine also lowered the proportion with anaemia from 100% at baseline to 36% at 12 weeks, and of iron deficiency from 66% at baseline to 8% at 12 weeks. Survival analysis showed no evidence of substantially increased risk of malaria after iron supplementation.
                Iron supplementation gives substantial health benefits, which may outweigh possible inherent risks caused by malaria. A larger study than ours is needed to assess benefits and risks of intermittent administration of sulfadoxine-pyrimethamine in reducing the incidence of malaria attacks in areas of seasonal malaria transmission. Three-quarters of preschool children in India are anaemic. With the aim of identifying a cost-effective strategy for iron supplementation, the study objective was to assess the effectiveness of daily versus biweekly iron-folic acid (IFA: 20 mg elemental iron and 0.1 mg folic acid/tablet) on change in haemoglobin (Hb) levels of preschool children (3-6 years). This was a rural community-based effectiveness study in Uttar Pradesh, North India. IFA was given in two schedules: biweekly (2 tablets/dose) and daily (1 tablet/dose) for 1 year with fortnightly monitoring for adherence. A total of 400 and 403 children were enrolled in daily and biweekly regimes, respectively, of which 57.32 per cent and 50.25 per cent were anaemic (Hb <11 g/dl) in each group. Adherence in biweekly and daily regimes was 89.05 per cent vs. 63.5 per cent. After 1 year, the mean Hb rise in daily and biweekly regime was 1.063 g/dl (SD: 1.6; p = 0.000) and 1.053 g/dl (SD: 1.73; p = 0.001), respectively. Reduction in point prevalence of anaemia was 65.7 per cent daily vs. 56.1 per cent in biweekly regimen (p = 0.0047). We conclude that biweekly as well as daily IFA administration is effective in raising Hb levels and decreasing community prevalence of anaemia significantly. However, since there is better adherence and lower drug costs associated with biweekly IFA administration, this can be considered for programme use. The aim of this study was to compare the effectiveness of weekly and daily iron supplementation in 6 to 24 months infants. One-hundred Infants enrolled into this randomized controlled field trail. Fifteen drops was prescribed for the group who received daily supplementation of iron and 30 drops was prescribed for the group who was set up to receive weekly supplementation of iron. Hemoglobin and serum ferritin was measured after 12 weeks. After 12 weeks results showed that both weekly and daily supplementation significantly increased hemoglobin but for serum ferritin daily supplementation was only significant. However, there was no significant difference between two groups, so the weekly supplementation is recommended. According to the results and more tendencies to the weekly regimen, we recommended weekly regimen versus daily Iron supplementation. Iron deficiency anemia (IDA) remains the most prevalent nutritional deficiency in infants worldwide. The purpose of this study was to determine the efficacy of daily and weekly iron supplementation for 3 months to improve the iron status in 4-month-old, exclusively breast-fed healthy infants. Infants 4 months of age were eligible for the open, randomized controlled trial if their mothers intended to continue exclusive breast-feeding until the infants were 6 months of age. Infants or mothers with iron deficiency (ID) or IDA on admission were excluded. The infants (n = 79) were randomly assigned to three groups, the first group receiving daily (1 mg/kg daily), the second group weekly (7 mg/kg weekly), and the third group no iron supplementation. Anthropometric measurements were taken on admission and at 6 and 7 months of age. Iron status was analyzed on admission and monthly for 3 months. Both hematologic parameters and anthropometric measurements were found to be similar among the three groups during the study period. Seven infants (31.8%) in the control group, six (26.0%) in the daily group, and three (13.6%) in the weekly group developed ID or IDA (P > 0.05). Infants whose mothers had ID or IDA during the study period were more likely to develop ID or IDA independently from iron supplementation. Serum ferritin levels decreased between 4 and 6 months of age in the control and daily groups; the weekly group showed no such decrease. In all groups, the mean levels of serum ferritin were significantly increased from 6 months to 7 months of age during the weaning period. In this study, which had a limited number of cases, weekly or daily iron supplementation was not found to decrease the likelihood of IDA. In conclusion, exclusively breast-fed infants with maternal IDA appeared to be at increased risk of developing IDA. Iron deficiency is a common nutritional problem in young children among vulnerable populations in Jordan. Several studies have shown the effectiveness of intermittent iron supplementation in improving iron status. Such a study has not been carried out in 2- to-6-year-old Jordanian children diagnosed with iron deficiency anemia in a clinical setting.
                To study the effectiveness of intermittent versus daily iron treatment in a clinical setting in 2- to 6-year-old Jordanian children with iron-deficiency anemia.
                About 4400 children aged 2 to 6 years who visited Prince Hashim Military Hospital in Zarqa, Jordan, from August 2000 to June 2001 were screened for age, general health, and birthweight. About 10% of these children were screened for anemia, using complete blood count (defined as a hemoglobin level < or = 10.5 g/dL, and a mean corpuscular volume < or =75 ft). Anemic children underwent further screening for iron deficiency, defined as serum ferritin level < or =12 microg/L. Children with iron-deficiency anemia, as indicated by hemoglobin < or = 10.5 g/dL, mean corpuscular volume < or =75 fL, and serum ferritin < or =12 microg/L, or as indicated by mean corpuscular volume < or =75 fL and hemoglobin < or = 10.5 g/dL, were enrolled in the study after informed oral consent by their parents. Study children (n=134) were assigned randomly to one of three groups. Subjects in group 1 (n=45), group 2 (n=45), and group 3 (n=44) received iron treatment daily, weekly, and twice weekly, respectively. Out of 134 children recruited for the study, only 63 (39 boys and 24 girls) completed the 3-month treatment period. All of the children received medicinal iron drops at a dosage of 5 mg elemental iron as ferrous sulfate per kilogram of body weight. The parents also received nutritional counseling.
                At the end of treatment, hemoglobin, serum ferritin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration increased significantly in all groups with no significant differences between groups. The increases in hemoglobin in groups 1, 2, and 3 were 2.47 +/- 0.17, 2.12 +/- 0.18, and 2.18 +/- 0.18 g/dL, respectively. Measurements of final serum ferritin concentration were available for only 12, 12, and 10 children in groups 1, 2, and 3, respectively. In all children who completed the study, except for one in group 1, hemoglobin, mean corpuscular volume, and serum ferritin reached normal values in response to iron treatment.
                Weekly and twice-weekly iron therapy with 5 mg elemental iron as ferrous sulfate per kilogram of body weight accompanied by nutritional counseling was as effective as daily iron therapy in correcting iron-deficiency anemia in 2- to 6-year-old children under the clinical conditions of this study. The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of >/= 90%. The mean haemoglobin (Hb) level increased by 8 g/l more in children on supplement (95% CI 3-12) during the 5-month study. All age groups benefited from the intervention including severely anaemic subjects. The mean erythrocyte cell volume (MCV) increased but Hb in children >/= 24 months improved independently of MCV and no relation was found with hookworm infection. The data therefore suggest that micronutrients other than iron also contributed to Hb improvement. In the supplement group of children who had received sulfadoxine-pyrimethamine (SP) treatment, the mean Hb level increased synergistically by 22 g/l (95% CI 13-30) compared to 7 g/l (95% CI 3-10) in those without such treatment. Supplementation did not affect malaria incidence. In conclusion, micronutrient supplementation improves childhood anaemia in malaria holoendemic areas and this effect is synergistically enhanced by temporary clearance of parasitaemia. To assess impact of daily and intermittent iron-folate (IFA) supplementation on physical work capacity of underprivileged schoolgirls in Vadodara.
                Randomized controlled trial.
                Municipal Primary schools.
                Schoolgirls (n=163) in the age group of 9-13 years.
                Three randomly selected schools were given IFA tablets (100 mg elemental iron + 0.5 mg folic acid) either once weekly or twice weekly or daily for one year. The fourth was the control school.
                Hemoglobin, modified Harvards Step test for physical work capacity.
                All three IFA supplemented groups showed significant improvement in number of steps climbed and recovery time compared to controls; with impact being relatively better in girls with higher Hb gain (> 1 g/dL) vs. lower Hb gain. Similarly, higher the frequency of dosing better was the impact- it being the best in daily IFA group. Twice weekly IFA was as good as daily IFA under conditions of good compliance.
                Twice weekly IFA supplementation is comparable to daily IFA in terms of beneficial effects on physical work capacity in young girls. A randomized, placebo-controlled, double-blind trial was carried out in 1994-96 among 231 children and 181 adults in order to determine the effects of iron on reinfection rates and intensities of hookworm, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni. Adults given 60 mg elemental iron twice-weekly for 12 months had significantly lower reinfection rates of A. lumbricoides (16.7% vs 31.9%, P = 0.046), T. trichiura (6.9% vs 20.6%, P = 0.03) and S. mansoni (38.3% vs 61.8%, P = 0.008) compared to adults given placebo. In contrast, adults allocated to iron had a significantly higher reinfection rate of hookworm at the 4-month examination (11.1% vs 0%, P = 0.009), but the difference was not significant at 8- and 12-month follow-up examinations. Iron supplementation had no effect on reinfection intensities in adults. Surprisingly, iron supplementation had no effect on either reinfection rates or intensities in children. Multiple logistic regression analyses controlling for baseline infection status confirmed the effect in adults of iron on A. lumbricoides, T. trichiura and S. mansoni reinfection rates. The effect is suggested to be due to reduced risk behaviour, to improved immune function or to unfavourable host gut conditions caused by an increased oxidative stress. In each case, the lack of effect in children remains to be explained. In contrast, iron supplementation apparently was short-lived in favour of hookworm infection, an effect that needs further clarification. The findings suggest that iron supplementation has a role to play in helminth control programmes and that intraluminal factors may contribute to the regulation of some helminth infections. To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers.
                Sixty schools were randomly assigned to two groups: in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid; in the other 30 schools no iron tablets were given. All children were dewormed and given vitamin A before the study began. The haemoglobin concentration of up to 20 randomly selected children in each school was estimated before and 2 weeks after the end of treatment.
                Rural community schools in Kolondieba district of Mali.
                Some 1113 schoolchildren aged 6-19 years with a mean of 11.4 years.
                The haemoglobin concentration of treated children rose on average by 1.8 g l(-1) and the prevalence of anaemia fell by 8.2%; in untreated children the haemoglobin concentration fell by an average of -2.7 g l(-1) and the prevalence of anaemia rose by 9.4%. The fall in haemoglobin concentration among untreated girls of -4.0 g l(-1) was greater than in untreated boys (-0.3 g l(-1) ).
                Weekly iron tablets given by teachers prevented a general fall in the haemoglobin concentrations of untreated children, and led to a small but statistically significant rise among treated children. Young children benefited more than children aged >or=12 years, and girls benefited more than boys. This study was designed to propose a more practical, effective, safer, inexpensive, and manageable alternative treatment of iron deficiency anemia (IDA) for the developing countries. The study involves 94 children between the ages of 5 months and 6 years who had been seen in the authors' hospital and diagnosed as having iron deficiency anemia. Ninety-four children with IDA were randomly divided into two groups: 48 children comprised the first group, which was administered conventional treatment, and 46 children comprised the second group, which was administered intermittent treatment involving iron administration 2 days a week. Twenty-three children whose age and gender distribution were compatible with the other groups were included in the study as the control group. Both groups were reevaluated for their initial hematologic parameters at the end of the treatment. When the parameters of both groups were compared with the parameters of the control group after the treatment, there were no differences between hemoglobin, hematocrit, red blood cell, mean corpuscular volume, mean corpuscular hemoglobin concentration, serum iron, and ferritin levels of conventional and intermittent treatment groups. With respect to certain parameters, such as red cell distribution, serum iron binding capacity, transferrin saturation, transferrin receptor, and transferrin receptor/log ferritin, however, intermittent treatment was superior to the conventional treatment method (p <.05). In IDA, when a conventional treatment method or an intermittent treatment method is used, there are no differences between the hematological parameters. In fact, the intermittent treatment method has been found to be superior in many parameters. nan To compare improvement in hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin and ferritin levels in children aged 5-10 years and women of reproductive age (15-45) supplemented with daily oral and once weekly with single and double dose of ferrous sulphate.
                Twenty children received 200 mg ferrous sulfate daily and 20 received the same dose once weekly for two months. Ten women received 300 mg ferrous sulfate daily, 10 received the same dose once weekly while 10 received 600 mg of ferrous sulfate once weekly for one month.
                All parameters improved significantly in children who received 200 mg ferrous sulfate daily and weekly. Similarly, the parameters improved significantly in women who received 300 mg of ferrous sulfate daily and 600 mg of ferrous sulfate weekly.
                Weekly supplementation of iron is far better in controlling iron deficiency anemia due to cost effectiveness and better compliance. To investigate the effect of 3 months iron supplementation on physical growth among anemic school children given daily and weekly and to know the response based on hemoglobin level.
                One hundred forty-four children were measured for height, weight and hemoglobin level. Ninety seven children were anemic (67.36%) with Hb level < 12 g/dl and forty seven children were non anemic. anemic children were divided into 2 subgroups and randomly assigned to either daily and weekly Fe treatment for 12 weeks. The non anemic group were treated with weekly iron supplementation, which was accepted by the parents.
                Children's height, weight, and hemoglobin of T1 and T2 food recall method was used to know calorie, protein, vitamin C and iron intake in both daily and weekly subgroups. Three days food recall was performed in the second and third months by a nutritionist.
                After iron supplementation, the hemoglobin level in both group increased significantly. The average change of hemoglobin between the 2 groups gave no significant difference. W/A and H/A after iron supplementation showed significantly increased in both groups. The average change of W/A and H/A between the 2 groups gave no significant difference.
                Daily and weekly iron supplementation showed no significant difference in increasing of hemoglobin level and physical growth. Further research must be done with appropriate sample size and well design. 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.
Intermittent iron supplementation is efficacious to improve haemoglobin concentrations and reduce the risk of having anaemia or iron deficiency in children younger than 12 years of age when compared with a placebo or no intervention, but it is less effective than daily supplementation to prevent or control anaemia. Intermittent supplementation may be a viable public health intervention in settings where daily supplementation has failed or has not been implemented. Information on mortality, morbidity, developmental outcomes and side effects, however, is still lacking.