title: A community-based cluster randomized controlled trial of "directly observed home-based daily iron therapy" in lowering prevalence of anemia in rural women and adolescent girls.
abstract: In a community-based cluster randomized controlled trial, we randomly assigned clusters of anemic women and adolescent girls to either "directly observed home-based daily iron therapy" (DOHBIT; n = 524 in 16 villages) or unsupervised self-treatment at home (n = 535 in 16 villages) for a period of 90 days. Those in the DOHBIT group, when compared with those in the unsupervised self-treatment group, had significantly lower relative risk (RR) of anemia (16.8% vs 35.3%, RR = 0.47 [95% confidence interval (CI) = 0.33-0.65]; P < .0001), higher hemoglobin (Hb) rise of ≥2 g/dL (70.2% vs 42.2%, RR = 1.56 [95% CI = 1.31-1.87]; P <.0001), and nonsignificant trend for lower side effects (3.5% vs 6.7%, RR = 0.49 [95% CI = 0.22-1.08; P < .08) on intention-to-treat analyses. On linear mixed model analysis, the subjects in the intervention group demonstrated higher mean Hb levels (13.01 vs 12.32 g/dL; P < .0001) and higher adherence to iron therapy (93% vs 60%; P < .0001). DOHBIT is effective in lowering the prevalence of anemia in rural women and adolescent girls.
authors.affiliation: Build Healthy India Movement, Jammu Tawi, Jammu & Kashmir, India sahulbharti@rediffmail.com.
authors.forename: Sahul
authors.initials: S
authors.lastname: Bharti
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Bhavneet
authors.initials: B
authors.lastname: Bharti
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Shano
authors.initials: S
authors.lastname: Naseem
authors.affiliation: Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Savita Verma
authors.initials: SV
authors.lastname: Attri
mesh_terms: D000293:Adolescent; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D019587:Dietary Supplements; D023801:Directly Observed Therapy / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D055118:Medication Adherence; D015995:Prevalence; D012306:Risk; D012424:Rural Population
chemical_list: D006454:Hemoglobins; D007501:Iron
keywords: adolescents; anemia; cluster randomized controlled trial; directly observed treatment; iron deficiency; iron supplementation; rural; women