Effect of Interventions on Iron-Deficiency Anemia Among School-Going Children in India: A Systematic Review and Network Meta-Analysis

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#child #humans #anemia-iron-deficiency #dietary-supplements #ferritins

Effect of Interventions on Iron-Deficiency Anemia Among School-Going Children in India: A Systematic Review and Network Meta-Analysis

Felix et al., 2025 | J Res Health Sci | Systematic Review

Citation

Felix Flemin, Karun Kalesh Mappilakudy, ... Roy Subarna. Effect of Interventions on Iron-Deficiency Anemia Among School-Going Children in India: A Systematic Review and Network Meta-Analysis. J Res Health Sci. 2025-Jun-10;25(3):e00651. doi:10.34172/jrhs.8985

Abstract

BACKGROUND: The prevalence of iron-deficiency anemia (IDA) among school-aged children in India varies from 27% to 90%. There is no evidence of the comparative effects of various available interventions. Thus, this study aimed to quantify and rank the effects of different interventions on IDA among school-going children. Study Design: Systematic review and Meta-analysis. METHODS: To this end, PubMed, Scopus, and ScienceDirect databases were searched, and randomized controlled trials (RCTs) evaluating the comparative effects of various interventions on hemoglobin (Hb) and serum ferritin against a control were included in this study. The random-effect model was conducted for Hb, and the fixed-effects model was performed for ferritin to estimate the mean difference (MD) and 95% confidence interval (CI) of the effect of interventions of outcomes based on the heterogeneity (I2 ). RESULTS: Eight RCTs (including 2534 participants) investigating the effects of 12 interventions for IDA treatment among school-going children in India were obtained. The results of reference-based forest plots and P score indicated that iron-rich fish powder was the most effective intervention for increasing Hb levels (MD: 2.07 g/dL, 95% CI: 0.68-3.47, P score=0.8656), followed by iron and folic acid (IFA) given twice weekly (MD: 1.47 g/dL, 95% CI: -0.31-3.25, P score=0.7209). Additionally, IFA supplementation twice weekly was found to be highly effective in increasing serum ferritin levels among anemic school children (MD: 0.80 ng/mL, 95% CI: 0.33-1.27, P score=0.9148). CONCLUSION: It seems that iron-rich fish powder and intermittent IFA supplementation were the most effective interventions, but further research is needed to confirm these results and assess their public health implications. Protocol Registration: PROSPERO registration number was CRD42024541802.

Key Findings

Eight RCTs (including 2534 participants) investigating the effects of 12 interventions for IDA treatment among school-going children in India were obtained. The results of reference-based forest plots and P score indicated that iron-rich fish powder was the most effective intervention for increasing Hb levels (MD: 2.07 g/dL, 95% CI: 0.68-3.47, P score=0.8656), followed by iron and folic acid (IFA) given twice weekly (MD: 1.47 g/dL, 95% CI: -0.31-3.25, P score=0.7209). Additionally, IFA supplemen

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 2534
Age Range See abstract
Condition deficiency

MeSH Terms

  • Child
  • Humans
  • Anemia, Iron-Deficiency
  • Dietary Supplements
  • Ferritins
  • Hemoglobins
  • India
  • Iron
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Network Meta-Analysis, Systematic Review
  • Vertical: iron

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09