To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia in adolescent Nepalese girls.
Randomized controlled trial.
A Government Girl School in Dharan, Nepal, an urban foothill town that is 305 m above sea level.
Consecutive healthy adolescent girls (n = 209, median age 15 years) randomized to 3 groups matched for age, anthropometry, and personal and sociodemographic characteristics. Of 209 subjects, 181 completed the trial. Two girls had adverse reactions to treatment and were excluded.
Group A (n = 70) received a 350-mg ferrous sulfate and 1.5-mg folic acid combination once daily for 90 to 100 days. Group B (n = 67) received the tablet under supervision once a week for 14 weeks. Group C (n = 72) did not receive any drugs.
Presupplementation and postsupplementation differences in prevalence of anemia and change in hematocrit.
Prevalence of anemia (defined as hematocrit <36%) declined from 68.6% and 70.1% in groups A and B to 20% and 13.4%, respectively, postsupplementation (P<.001), whereas the prevalence in group C changed little (68.1% to 65.3%, P = .81). There was a significant rise in the mean hematocrit of both supplemented groups (group A, 32.9% ± 3.5% to 41.0% ± 5.6%, P<.001; group B, 33.2% ± 3.6% to 40.4% ± 4.9%, P<.001) but no appreciable change in controls (34.2% ± 2.9% to 34.1% ± 3.3%, P = .91). Net change in mean hematocrit in both the supplementation groups was comparable (P = .57).
The prevalence of anemia in adolescent Nepalese girls is high. Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anemia in adolescent girls.