OBJECTIVE: To evaluate the effect of once weekly versus daily iron supplementation in improving hematologic status of children with iron deficiency anemia through a meta-analysis of randomized controlled trials. SEARCH METHODS: Both electronic and manual means were employed to search for trials irrespective of language or publication status. Highly sensitive search terms used were "randomized controlled trials", weekly iron supplementation", "daily iron supplementation" and "iron deficiency anemia". SELECTION CRITERIA: Randomized controlled trials comparing the effects of weekly and daily iron therapy in improving hemoglobin, hematocrit and serum ferritin levels of anemic children were reviewed. DATA COLLECTION AND ANALYSIS: Three reviewers independently appraised methodologic quality and extracted data. Analysis was implemented with the Review Manager version 5.0 using weighted mean difference as the treatment effect measure. All outcome variables were analyzed for evidence of heterogeneity. RESULTS: The search yielded 97 articles, of which 5 were finally selected. A total of 385 anemic children from developing countries were given weekly and daily iron supplementation for 2 to 6 months. Results of individual journals reported significant increase in levels of hemoglobin, hematocrit and serum ferritin level pre- and post supplementation. Anemia was corrected in all patients irrespective of whether they receive daily or weekly iron therapy. A significant difference was observed favouring daily supplementation in increasing hemoglobin values (MD 3.69, 95% CI 2.39 to 4.98) of all 385 subjects. Whereas no statistical difference was found between both groups with regards to raising hematocrit (MD 0.02, 95% CI -1.78 to 1.83) and serum ferritin (MD 3.15, 95% CI -6.43 to 12.74) levels of 135 and 84 subjects respectively. CONCLUSION: weekly iron supplementation is comparable to the standard daily regimen in improving hemoglobin, hematocrit and serum ferritin levels of anemic children.
To evaluate the effect of once weekly versus daily iron supplementation in improving hematologic status of children with iron deficiency anemia through a meta-analysis of randomized controlled trials.
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