Weekly iron-folic acid supplementation combats iron, folate deficiency in young girls

In low- and middle-income countries, a community-based weekly iron-folic acid supplementation (WIFAS) programme appears to be an effective tool to reduce iron and folate deficiency in adolescent girls, a recent study has found.

To assess the efficacy of WIFAS, the researchers conducted a randomized controlled trial across four villages in Ethiopia, enrolling 226 adolescent girls (aged 10–19 years). The two study arms were WIFAS and a no-intervention control, each including 113 participants. Outcome included serum ferritin (SF), serum folate (SFol), and C-reactive protein (CRP) levels, measured at baseline and after the 3-month trial period.

Randomization was conducted well, such that mean baseline levels of haemoglobin, SF, SFol, and CRP were comparable between arms. At the 3-month assessment, however, significant differences in marker concentrations were observed between groups.

Haemoglobin, for instance, was significantly higher in WIFAS adolescents (14.5±1.3 vs 13.2±0.7 g/dL; p<0.001) than in control comparators. The same was true for SF (97.8±68.2 vs 63.1±45.9 µg/dL; p<0.001) and SFoL (14.3±4.6 vs 11.4±4.3 ng/mL; p<0.001), but not for CRP (p=0.353).

Notably, none of the participants in the WIFAS arm had a depleted iron store or were deemed to be folate-deficient, as defined by a concentration <6 ng/mL. In contrast, over 3 months of intervention, control participants saw no significant change in their haemoglobin, SF, or SFol concentrations.

Multivariate linear regression confirmed that the WIFAS programme was significantly beneficial for end-of-study haemoglobin, SF, and SFol, such that lower baseline levels seemed to enhance the effect of WIFAS.

“The present finding suggests the potential benefit of scaling-up community-based WIFAS programmes in Ethiopia and beyond,” the researchers said. “Future studies should evaluate the long-term benefits of such programmes.”