Efficacy of alternate day versus daily oral iron therapy in children with iron deficiency anemia –a randomized control trial

Abstract

Background: Anemia means reduction in the Hb level, RBCs and hematocrit level below the expected normal range, for a given age as well as gender. It is the most important health problem, particularly in the developing countries, affecting approximately 33% of the paediatric population in the world. One of the commonest cause of nutritional anemia in India is IDA. Despite proper oral iron supplementation, optimal outcomes may not always be reached due to poor absorption and low adherence to the treatment. High doses of iron can also cause gut inflammation, which may result from irritation of the gut lining by elevated free iron concentration, leading to treatment failure. Hepcidin is an important regulatory molecule in Fe metabolism. Hepcidin binds to ferroportin, Fe transporter, which is mainly expressed on enterocytes, hepatocytes and macrophages, leading to degradation of ferroportin. High serum hepcidin reduces dietary Fe absorption and recycling of Fe from senescent erythrocytes. Hence the aim for our study is to assess, the effectiveness of alternate day Fe supplementation compared to daily supplementation in children with IDA and to see its effect on serum hepcidin levels and to compare the GI side- effects in the two groups which may affect compliance.