Impact of weekly treatment with ferrous sulfate on hemoglobin level, morbidity and nutritional status of anemic infants

Abstract

Objective: To evaluate the impact of weekly treatment with ferrous sulfate on hemoglobin level, morbidity and nutritional status in a sample of anemic infants from Zona da Mata Meridional in the state of Pernambuco, Brazil.Methods: A controlled, community-based intervention was carried out with 378 infants who were followed-up for 18 months. Hemoglobin level was measured at 12 months in a total of 245 children randomly selected. Participating infants were divided into three groups: two received 45 mg of elemental iron weekly, from 12 to 18 months of life (69 children with moderate/severe anemia, and 111 with mild anemia); the third group was composed of 65 non-anemic children, who received no intervention. The remaining 133 children constituted the control group, for comparisons on nutritional status and morbidity.Results: The prevalence of anemia was 73.5% at 12 months of life. After 6 months of treatment, 42.3% of anemic children reached hemoglobin levels ≥ 11.0 g/dL. The mean increase was 1.6 g/dL, being higher (2.5 g/dL) in the group with lower levels of hemoglobin at baseline. Children without anemia at baseline received no treatment, and 40.3% of them became anemic at the end of follow-up, with a mean decrease of 0.5 g/dL in hemoglobin levels. A significantly greater weight gain was observed in the two treated groups, while no significant improvements were seen in linear growth and duration of diarrhea. Conclusions:The fact that less than half the children receiving ferrous sulfate recovered from anemia at the end of follow-up, along with the development of anemia in many untreated, previously nonanemic infants, suggests the need for effective control strategies.J Pediatr (Rio J). 2006;82(6):452-7: Anemia, hemoglobin level, iron, weekly treatment, infant. ResumoObjetivo: Avaliar o impacto do tratamento com sulfato ferroso, administrado semanalmente, sobre o nível de hemoglobina, morbidade e estado nutricional de lactentes anêmicos da Zona da Mata Meridional de Pernambuco.Métodos: Estudo de intervenção de base comunitária, controlado, realizado com 378 lactentes acompanhados até 18 meses. Foram selecionadas aleatoriamente 245 crianças para avaliação da hemoglobina aos 12 meses. As crianças foram distribuídas em três grupos de estudo: dois com tratamento semanal de 45 mg de ferro elementar, dos 12 aos 18 meses de vida (69 crianças com anemia moderada/grave e 111 com anemia leve) e um sem tratamento, constituído de 65 crianças sem anemia. As 133 crianças restantes constituíram o grupo controle, utilizado para comparação do estado nutricional e da morbidade.Resultados: A prevalência de anemia foi de 73,5% aos 12 meses de vida. Após 6 meses de tratamento, houve recuperação do nível de hemoglobina para valores ≥ 11,0 g/dL em 42,3% dos lactentes anêmicos. O aumento médio foi de 1,6 g/dL, sendo maior (2,5 g/dL) para o grupo com nível inicial mais baixo de hemoglobina. Das crianças sem anemia e não tratadas, 40,3% tornaram-se anêmicas ao término do acompanhamento, com uma redução média do nível de hemoglobi...

Efficacy of different strategies to treat anemia in children: a randomized clinical trial

“…Gera and Sachdev reviewed several trials and found that iron supplementation increases the risk of developing diarrhea by 0.05 more episodes per year, which is considered a low risk [33]. Similar to other studies [34,35], this study did not find a difference in diarrhea episodes among treatments.…”

Prevalence and Severity of Anaemia Among Hospitalised Children Aged 6-59 Months

“…20 Prevention of anaemia due to whatever aetiology will reduce the incidence of LRTI. 19 Most studies could not find any relation between the prevalence of anaemia and length of hospitalisation. The length of hospital stay may be related to other factors such as the severity of the disease, presence of other complications and care.…”

“…Lima et al reported a higher prevalence of anaemia in infants with infectious diarrhoea. 19 Ramkrishna K et al studied haemoglobin level as a risk Factor for Lower Respiratory Tract Infections and identified anaemic children were 5.75 times more prone to lower respiratory infections compared to the control group. 20 Prevention of anaemia due to whatever aetiology will reduce the incidence of LRTI.…”

Evaluation of the Effect of Ferrous Sulfate on Enamel Demineralization of Human Deciduous Teeth: An in Vitro Study

“…In Brazil, IDA is a major health problem, and its occurrence varies between 40% and 60% among children less than 2 years old [2][3][4] ; among children with anemia aged between 12 and 16 months, 95% have iron deficiency 2 .…”

“…Because it is a lowcost treatment, has high absorption and solubility, and improves the nutritional status quickly, this preventive treatment starts at an early age. Iron supplements are well tolerated by most infants, have no measurable effect on body growth in children, and early iron supplementation, even in breastfed infants, is feasible and transiently increases iron status 4 . FS has been analyzed in several studies in dentistry [5][6][7][8][9][10][11][12][13] using artificial dental models (mainly bovine teeth and human permanent teeth).…”