Should Iron Supplementation be Daily or Weekly?
Two published papers
Nutrition guidelines for emergency programmes currently advocate a daily supplement of ferrous sulphate (100 mg/day) after fifteen days in therapeutic feeding programmes and daily for all anaemic children in supplementary feeding programmes from admission. However, two recent research studies under-taken in non-emergency situations suggest that weekly iron supplementation may be as effective as daily supplementation in restoring haemoglobin levels. These and other similar findings could have important implications for iron supplementation strategies as weekly supplementation in emergency or non-emergency situations would reduce costs and possibly increase subject compliance. One study compared the efficiency of daily versus weekly supplementation in a group of anaemic children living in a socio-economically disadvantaged district of high altitude La Paz in Bolivia. The children in this study were aged between 3-8 years and were split into three groups. One group was a placebo group (n=57) while the other two groups (n=58 for both other groups) were given a dose of 3-4 mg of elemental iron per kg body weight each week, or for five days a week over a 16 week period. Therefore, those who were supplemented daily received five times as much iron as those who were weekly supplemented. After 16 weeks of iron supplementation, 87.2% of the children receiving weekly supplementation and 82.7% of the group receiving the five day per week supplementation were no longer anaemic whereas only 5.4% of the placebo control group were non-anaemic. The study concluded that daily and weekly supplementation were equally efficient.
The full article can be found in the European Journal of Clinical Nutrition 1997, Vol. 51, pp 381-386
A second recent study in Indonesia reported similarly impressive results with weekly supplementation. The effect of weekly iron supplementation on haemoglobin with and without deworming on haemoglobin was investigated in 289 pre-schoolers randomly divided into three groups. Group 1 and 2 received 30 mg of iron once weekly for nine weeks and group 3 received a placebo over the same period. Group 1 additionally received antihelminthic treatment. Supplements were administered by mothers who were educated about iron deficiency beforehand. In the iron supplemented groups prevalence of anaemia decreased from 37.2% to 16.2%. Antihelminthic treatment did not have an additional effect
The full article: Effective community intervention to improve haemoglobin status in pre-schoolers receiving once weekly iron supplementation. AM J Clin Nutr J997;65.1057-61
More like this
FEX: Micronutrient powders v iron-folic acid tablets in controlling anaemia in pregnancy
Summary of research1 The major cause of anaemia in pregnancy is iron deficiency, which is preventable. It is estimated that 56% of pregnant women in developing countries...
en-net: Screening and Treatment protocols in Anaemia amongst adolescent girls
At Jharkhand, India over 70-90% of Adolescent girls are anaemic. The State provides a once-a-week IFA supplement at schools to prevent anaemia amongst adolescents girls. Last...
FEX: Fortified balanced energy protein supplementation for pregnant women in Burkina Faso
View this article as a pdf This is a summary of the following paper: Hanley-Cook G, Toe LC, Tesfamariam K et al (2022) Fortified balanced energy-protein supplementation,...
FEX: Current evidence on anaemia and micronutrient supplementation strategies in school-age children and adolescents
View this article as a pdf Lisez cet article en français ici By Elena Hemler, Wafaie Fawzi and Stephanie Wrottesley Elena Hemler is senior project coordinator for the...
FEX: Antibiotics as part of the management of severe acute malnutrition
Summary of published research1 Mothers receive instruction on how to adminster antibiotics Location: Malawi What we know already: There is a high prevalence of clinically...
FEX: Prevalence of Anaemia Amongst Young Children in Argentina
By Adrian Díaz, Amador Gómez, Nuria Salse and Gabriela Cormick Adrian Díaz is a physician and Technical Coordinator for ACH in Argentina. He has worked with MSF in Honduras on...
FEX: Non-nutrition interventions to prevent anaemia in school-age children and adolescents
View this article as a pdf Lisez cet article en français ici By Natalie Roschnik, Andrew Hall, Moussa Sacko and Sian Clarke Natalie Roschnik is Senior Nutrition...
FEX: Routine amoxicillin use in treatment of uncomplicated SAM in children
Summary of research1 Location: Niger What we know: Routine use of broad-spectrum antibiotics is recommended in uncomplicated SAM case management; there is a lack of evidence...
FEX: Effect of adding RUSF to ageneral food distribution on child nutritional status and morbidity: a cluster randomised controlled trial
Summary of research1 Child during appetite test at a health facility offering treatment in Monrovia, Liberia The authors of a recent study hypothesized that including a daily...
FEX: Thiamine content of F-75 for complicated severe acute malnutrition: time for a change?
Summary of research1 Location: Global What we know: Complicated cases of severe acute malnutrition (SAM) are usually severely ill with comorbidities. What this article adds:...
FEX: Potential of Using QBmix to Prevent Micronutrient Deficiencies in Emergencies
By Evelyn Depoortere, Epicentre Evelyn Depoortere is currently a medical epidemiologist for Epicentre. Previously she worked on several MSF missions, including Southern Sudan...
FEX: Development of a maternal service package for mothers of children with severe acute malnutrition admitted to nutrition rehabilitation centres in India
View this article as a pdf Lisez cet article en français ici By Vani Sethi, Praveen Kumar and Arjan De Wagt Vani Sethi PhD is a public health nutritionist in the...
FEX: Nutrition incentives in dairy contract faming in northern Senegal
Summary of research1 Location: Senegal What we know: Seasonality plays an important role in milk production in Senegal; milk production is the cornerstone of nutrition,...
FEX: Scalable integrated early child development programme using a conditional cash transfer programme in Colombia
Summary of research1 Location: Colombia What we know: Poverty and the associated poor nutrition and lack of psychosocial stimulation are associated with poor child...
FEX: Iron and vitamin A deficiency in African refugees
Summary of published research1 Haemacue survey in Tanzania Five cross-sectional surveys were conducted in refugee camps in north and east Africa between 2000-2002 to assess...
FEX: Results and lessons learned from WFP’s efforts to support adolescent girls in Niger
By Alexandra Pirola, Benedict Tabiojong Mbeng and Mica Jenkins View this article as a pdf Lisez cet article en français ici Benedict Tabiojong Mbeng is Head of...
en-net: Vitamin A supplemntation for severe wasting
Is it contraindicated to give Viatamin A for severe wasting during admission given the child didn't received in the last six months? until recently, my information was not to...
en-net: MNPs for children and sickle cell anaemia
Is it safe (and/or what are the risks) to give micronutrient powders to children (6-23 months) in a country where endemic rates of sickle cell anaemia are very high (recently...
Nepal’s success story: What helped to improve maternal anaemia?
View this article as a pdf Dr Ram Padarath Bichha is Director of the Family Welfare Division, Department of Health Services, Ministry of Health and Population, Nepal. Kedar...
FEX: Antioxidant Role in Preventing Kwashiorkor
Summary of published research1 A village of mothers waiting to enroll their children in Chipalonga A recent study set out to evaluate the efficacy of antioxidant...
Reference this page
Should Iron Supplementation be Daily or Weekly?. Field Exchange 3, January 1998. p6. www.ennonline.net/fex/3/should
(ENN_3286)