scholarly journals Iron-Supplementation Programmes: Compliance of Target Groups and Frequency of Tablet Intake

1996 ◽  
Vol 17 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Werner Schultink

The prevalence of iron-deficiency anaemia remains especially high in developing countries, despite large-scale iron-supplementation programmes. The reasons for the lack of success of these programmes are discussed based on the results of original research conducted in Indonesia. Studies among pregnant women in rural Sulawesi and urban Jakarta demonstrated that besides insufficient coverage of the target group, women's compliance with tablet intake was a serious problem. Compliance may be improved when it is not necessary to take tablets on a daily basis. Studies among pre-school children and non-pregnant women proved the effectiveness of once-weekly and twice-weekly supplementation. These supplementation schedules should also be investigated in pregnant women.

1996 ◽  
Vol 17 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Muhilal ◽  
Iman Sumarno ◽  
Komari

Iron-deficiency anaemia is one of the main nutritional problems in Indonesia, with a prevalence of 63.5% in pregnant women and 55.5% in pre-school children. Its frequency is related to low iron and folic acid contents of the diet. Intervention programmes to alleviate irondeficiency anaemia are iron tablets for adults, iron syrup for infants and schoolchildren, and iron fortification of foods. Our studies have demonstrated that iron supplementation can reduce the prevalence of anaemia in pregnant women by 20% to 25%, and iron fortification can reduce it by 20% for those consuming the fortified foods. If iron-supplementation, iron-fortification, and diet-modification programmes were fully implemented in a community, the expected reduction in the prevalence of anaemia would be greater.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Plaxcedia Mahundi ◽  
Kirthee Pillay ◽  
Nicola Wiles

The optimal use of iron supplements by pregnant women is important in ensuring healthy pregnancy outcomes. However, some barriers may prevent the optimal use of iron supplements by pregnant women in developing countries, subsequently resulting in iron deficiency anaemia, threatening the health of the pregnant woman and the fetus. This study aimed to identify possible barriers to optimal iron supplementation among pregnant women and possible strategies for alleviating these barriers. This cross-sectional study was conducted at the Mutare City Clinic in Manicaland, Zimbabwe. A total of 64 Black African pregnant women aged between 17 and 39 years participated in 8 focus group discussions. The pregnant women identified several barriers to the optimal use of iron supplements. The major barriers were poor compliance mainly due to erratic supplies of iron supplements at the healthcare centre, inadequate nutrition education on the benefits of iron supplements, side effects, and religious and cultural beliefs. Poverty and the influence of family members were other barriers. Most pregnant women were accustomed to receiving iron supplements free of charge from the healthcare centres and could not afford to buy them from private pharmacies. Despite erratic supplies at healthcare centres, continuous reinforcement of positive iron supplementation could motivate pregnant women to take iron supplements. Intensive nutrition education programmes may help to improve perceptions of women towards iron supplements. This could possibly help to overcome barriers to optimal iron supplementation, and thus reduce the prevalence of iron deficiency anaemia among pregnant women in Zimbabwe.


BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021793 ◽  
Author(s):  
Kathryn Bunch ◽  
Nia Roberts ◽  
Marian Knight ◽  
Manisha Nair

ObjectiveTo conduct a systematic review to investigate the safety of induction and/or augmentation of labour compared with spontaneous-onset normal labour among pregnant women with iron-deficiency anaemia.DesignSystematic review.SettingStudies from all countries, worldwide.PopulationPregnant women with iron-deficiency anaemia at labour and delivery.InterventionAny intervention related to induction and/or augmentation of labour.Outcome measuresPrimary: Postpartum haemorrhage (PPH), heart failure and maternal death. Secondary: Emergency caesarean section, hysterectomy, admission to intensive care unit.MethodWe searched 10 databases, including Medline and Embase, from database inception to 1 October 2018. We included all study designs except cross-sectional studies without a comparator group, case reports, case series, ecological studies, and expert opinion. The searches were conducted by a healthcare librarian and two authors independently screened and reviewed the studies. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approachto ascertain risk of bias and conducted a narrative synthesis.ResultsWe identified 3217 journal articles, 223 conference papers, 45 dissertations and 218 registered trials. Ten articles were included for full-text review and only one was found to fulfil the eligibility criteria. This was a retrospective cohort study from India, which showed that pregnant women with moderate and severe anaemia could have an increased risk of PPH if they underwent induction and/or augmentation of labour, but the evidence was weak (graded as ‘high risk of bias’).ConclusionThe best approach is to prevent anaemia, but a large number of women in low-to-middle-income countries present with severe anaemia during labour. In such women, appropriate peripartum management could prevent complications and death. Our review showed that at present we do not know if induction and augmentation of labour is safe in pregnant women with iron-deficiency anaemia and further research is required.PROSPERO registration numberCRD42015032421.


2005 ◽  
Vol 05 (01) ◽  
pp. 01-18
Author(s):  
JK Kikafunda ◽  
◽  
P Sserumaga ◽  

Iron deficiency anaemia (IDA) is the most widespread micro-nutrient deficiency disease world-wide, particularly in developing countries. Although there are several strategies to combat IDA, food-based strategies are the most sustainable and yet little research has been carried out in this area. The study aimed at developing a technology for processing and preserving bovine blood into a shelf-stable powder, which would easily be utilised in fortifying commonly consumed food items, as a food-based strategy in the fight against iron deficiency anaemia. A shelf-stable powder was processed from fresh bovine blood and the physical, chemical, microbiological and shelf-life characteristics assessed using conventional methods. The results of the chemical analysis showed that bovine blood powder has a very high concentration of haeme iron at 195.46 mg/100g of powder. This is more than ten times the level of iron in bovine liver, one of the most commonly used food source of haeme iron whose iron content is only 17 mg/100gm of liver. Although microbiological tests carried out on the freshly processed blood powder and on the same powder after one and three months of storage at room temperature found a significant rise in yeast, mould and total plate counts, these values were low and within safe limits. The blood powder was used to fortify a bean sauce. Sensory analysis panellists considered the fortified bean sauce moderately acceptable with a mean score of 4.667 (like slightly) compared to a mean score of 2.333 (like very much) for the non-fortified sauce, on a nine point Hedonic scale. These findings show that processed bovine blood powder has very high levels of haeme iron and thus has great potential as a food-based strategy to combat iron-deficiency anaemia in resource-poor developing countries, particularly those in sub-Saharan Africa. However, more research is needed to improve the microbiological and sensory characteristics of the blood powder.


Author(s):  
Kohila Kalimuthu ◽  
Vanusha Avudaithangam

Background: Moderate anaemia seen in about 15-20% of pregnant women. Iron sucrose complex which is used intravenously for the correction of Iron deficiency anaemia. The drug has been able to raise the haemoglobin to satisfactory level when used in moderately anaemic iron deficient pregnant women. The objective of this study was to study the improvement of Hb% after treatment with intravenous Iron sucrose complex in moderately anaemic pregnant women belonging to 24-32 weeks of gestational age.Methods: 50 antenatal patients between gestational age 24-32 weeks with hemoglobin between 8-9.5g/dl were selected and included in this study. They were subjected to blood hemoglobin estimation, hematocrit and peripheral smear study. In each infusion, the maximum total dose administered was 200 mg iron sucrose in 100 ml of normal saline, slow IV infused over 30 minutes. Monitoring was done throughout the infusion to observe for any side effects.Results: Mean hemoglobin among the 50 patients before starting the therapy was 8.172g/dl and the mean hemoglobin at the end of one month of completing the therapy was 11.066g/dl. The rise in mean hemoglobin i.e. the difference in the mean hemoglobin before and after treatment was 2.894g/dl. The p value is 0.0001 which is statistically significant. The mean hematocrit of the 50 patients studied before starting the treatment was 26.772% with a standard deviation of 1.914. The mean hematocrit after completing the therapy was 33.872% with a standard deviation of 1.321. The difference in the mean hematocrit was 7.100% with a p value of 0.0001 which is statistically significant.Conclusions: Intravenous iron sucrose complex is well tolerated and highly efficacious in improving hemoglobin, hematocrit in the treatment of iron deficiency anaemia in antenatal women.


2002 ◽  
Vol 5 (5) ◽  
pp. 619-624 ◽  
Author(s):  
Paul Prinsen Geerligs ◽  
Bernard Brabin ◽  
Albert Mkumbwa ◽  
Robin Broadhead ◽  
Luis E Cuevas

AbstractObjective:To evaluate acceptability, compliance and attitude towards the use of iron pots compared with aluminium pots, for cooking in a community that traditionaly did not use iron pots.Design:Randomised trial.Setting:Two rural Malawian villages.Subjects:Fifty-two households received iron pots and 61 aluminium pots.Results:Pot characteristics were assessed by a questionnaire after 3, 6, 11 and 20 weeks of use. Within households using iron pots there was a significant decrease in acceptability score with usage, from an initial value of 13.7 to 11.4 (range 1–20) (P = 0.01). Answers to questions concerning cooking characteristics showed that after 3 weeks' use the aluminium pot scored better, whereas after 20 weeks fewer answers differed between the iron and aluminium pot groups. Almost a third of the households planned to continue using iron pots daily after 20 weeks, although they had ready access to their former aluminium pot. The presence of a group of consistent pot users suggests that if households were convinced about daily use, then they were likely to maintain consistent use. Some householders considered that iron pots required less firewood for cooking than aluminium pots. The main problems related to lower acceptability were rusting and pot weight. About 25% of problems with iron pots were unrelated to their cast iron characteristics. Overall 23.4% of the households indicated they would buy an iron pot.Conclusions:The low acceptability of iron pots for cooking could limit their value as an intervention to control iron-deficiency anaemia. Design modifications and better instructions on pot use should improve acceptability. The study highlights the need to assess the acceptability of interventions in order to facilitate their adoption in traditional communities.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026497 ◽  
Author(s):  
Desmond Aroke ◽  
Benjamin Momo Kadia ◽  
Tsi Njim

IntroductionSickle cell disease (SCD) is the most common inherited disease worldwide. The greatest disease burden is seen in sub-Saharan Africa. Early diagnosis and improved care of people living with SCD have led to an increase in the number of women with SCD reaching the reproductive age. Iron deficiency anaemia remains the most common cause of anaemia in pregnancy, affecting 51%–63% of pregnancies in Africa. However, the unavailability of guidelines on supplementation of iron in this pregnant subpopulation often leaves clinicians in a fix. We propose to conduct the first systematic review and possibly a meta-analysis on the prevalence, associated factors and maternal/fetal outcomes of iron deficiency anaemia among pregnant women with SCD.Methods and analysisWe will search the following electronic databases for studies on the iron status of pregnant women with SCD: PubMed, MEDLINE, EMBASE, Google Scholar, African Journals Online, African Index Medicus, Popline and the Cochrane Library. After the selection of eligible studies from the search output, review of full text, data extraction and data synthesis will be performed. Studies obtained from the review shall be evaluated for quality, risk of bias and heterogeneity. Appropriate statistical methods shall be used to pool prevalence estimates for matching studies globally and in subpopulations. This protocol has been reported as per the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationThere is no requirement for ethical approval as the proposed study will use published data. The findings of this study will be published in a peer-reviewed journal and will be presented at conferences.Trial registration numberCRD42018109803.


Author(s):  
D.E. Kenny ◽  
W.E. Braselton ◽  
R.A. Taylor ◽  
T. Morgan ◽  
R.B. Hesky

A 38-day-old male warthog (Phacochoerus aethiopicus) with marked anaemia (haematocrit = 14 %) presented to the Denver Zoological Gardens hospital with ataxia, tachypnoea, suspected stunted growth and cardiomegaly. The piglet demonstrated some features consistent with both iron deficiency anaemia and autoimmune haemolytic anaemia. Serum-soluble iron was below the level of detection (<8.96 mmol/l). Iron deficiency anaemia is a well recognised entity in domestic swine reared on concrete and denied access to soil. Fifteen captive warthogs were subsequently evaluated for serum soluble iron content (mean = 21.62±4.36 mmol/l) as well as 5 neonatal warthog piglets that required hand-rearing. Only 1 of 5 neonatal warthog piglets had measurable serum soluble iron (9.50 mmol/l). These data suggest that warthogs are similar to domestic swine and are born with low iron stores. Some form of iron supplementation should be considered for captive neonatal warthog piglets, especially if they are reared on concrete.


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