Weekly iron supplementation is as effective as 5 day per week iron supplementation in Bolivian school children living at high altitude

Abstract

Objective: To compare the efficacy of a daily and a weekly iron supplementation on the hematological status of anemic children living at high altitude.

Design: Double blind iron supplementation trial including a placebo control group.

Setting: A socioeconomically disadvantaged district of La Paz, Bolivia (altitude of 4000 m).

Subjects: Anemic (hemoglobin concentration < or = 144 g/L), 3.3-8.3 y old children of both sexes.

Intervention: 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.

Results: 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.

Conclusion: 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.

Sponsorship: Program supported in part by ORSTROM, the French Ministry of Foreign Affairs and the National Secretary's Office of Health, Bolivia.