04 fmh030 Siddiqui (k)

Malnutrition can take a variety of forms, such as protein–energy malnutrition, and deficiencies of micronutrients, such as iron, iodine, and vitamin A. Among various forms of nutritional deficiencies in children, iron deficiency is the most common form that subsequently results in iron deficiency anemia (IDA). Consequences of IDA are serious and include reduced school performance, decreased growth rate, and impaired motor development. A number of strategies have been suggested to combat this problem including dietary modifications, fortification of food, and iron supplementation orally or parenterally. Among these strategies, daily oral supplementation with medicinal iron for 2–4 months is considered the most effective. Despite its effectiveness, non-compliance is the major problem with this strategy due to gastrointestinal side-effects and difficulty in sustaining motivation to take iron supplements daily for long periods of time. To overcome the problem of non-compliance with daily iron supplementation, researchers have investigated intermittent iron supplementation as an alternative form of therapy. Several animal and human studies have shown equal effectiveness and less gastrointestinal side-effects when intermittent was compared with daily iron supplementation. The rationale for intermittent oral iron supplementation is based on the concept of a ‘mucosal block’ of iron absorption. This theory argues that mucosal enterocytes downregulate iron absorption in response to daily exposure to a high intake of iron. There is an increase in mucosal ferritin synthesis, an increase in the proportion of enterocyte iron that is stored in the cell, and a decrease in transfer of iron to transferrin in the vascular pool. The life span of mucosal cells is 2–3 days and they are sloughed off and replaced by new cells. Therefore, stored iron within the mucosal cells is wasted instead of being absorbed. The aim of this study was to evaluate the effectiveness of weekly administration of iron supplements compared with daily administration in iron-deficient schoolchildren.