Daily vs alternate day oral iron therapy for treatment of mild and moderate iron deficiency anemia in children aged 5-18 years: A prospective open-labeled randomized controlled trial

Iron deficiency anemia (IDA) is a global health problem and the most common cause of anemia worldwide.  About half of the world’s cases of anemia are thought to be due to iron deficiency. In the world, approximately 25 % of school age children are anemic. World Health Organization (WHO) defines anemia as a hemoglobin less than 11.5 g/dl and 12 g/dl for children between 5-12years and 12-14 years respectively . Although the definition of anemia is well accepted, the definition of IDA is less standardized. Based on a systematic review conducted to determine the diagnostic value of laboratory tests in the diagnosis of ID, serum ferritin was found to be the most predictive and a better diagnostic test than mean cell volume (MCV) and transferrin saturation (TSAT)  To ensure a population with a high likelihood of IDA for this study, ID has been frequently defined as a serum ferritin of less than 15 microgram per liter in children more than 5 years. Oral iron therapy is an inexpensive and effective means of replenishing iron stores in iron deficiency anemia. Traditionally, oral iron salts are taken one or two times a day daily.  Recent studies done in population more than 15 years of age suggest that lower doses and alternate day administration may be as effective as the traditional regimen while probably associated with lower rates of adverse effects. In our region, no such studies have been conducted in children with iron deficiency anemia. Therefore, this study is planned for children aged 5 to 12 years with iron deficiency anemia.