ABSTRACT
Background: Intravenous iron is associated with oxidative stress, and very few studies have assessed change in oxidative stress markers post infusion. Objectives: The study aimed to measure the change in levels of hemoglobin (Hb), serum ferritin, and select oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], and ferric reducing ability of plasma [FRAP]) 4 weeks following the administration of intravenous iron sucrose (IVIS) among moderately anemic pregnant women who were attending a secondary-level health-care facility, Haryana, North India. Methods: An observational study was conducted (May 2016 to Jan 2018) among pregnant women receiving intravenous iron sucrose i.e., IVIS (300 mg per dose) diluted in 300 mL of normal saline over 20� min and were followed up for a period of 4 weeks after the last dose of IVIS (end line). The study outcomes were measured in the levels of Hb, serum ferritin, MDA, SOD, and FRAP from the baseline to the end line. Results: The mean (95% confidence interval) change in the Hb and serum ferritin level 4 weeks after the last dose of IVIS was an increase of 2.5 (2.1�0) g/dL (P < 0.001) and 63.0 (44.7�.3) ng/mL (P < 0.001), respectively. There were no significant changes (baseline to end line) in mean (standard deviation [SD]) MDA level and mean (SD) FRAP level. The mean (SD) SOD level declined significantly (2.2 [0.4] U/mL to 1.6 [0.5] U/mL [P < 0.001]). No life-threatening adverse events were encountered during the study. Conclusion: IVIS was well tolerated and effective in treating moderate anemia in pregnancy. Body iron store was replenished following IVIS administration. There was no increase in oxidative stress following IVIS therapy.
ABSTRACT
Point of care tests (POCT) are critical to success of public health programs like anemia control program which involve measurement of biomarkers; as they help in prompt decision making during first (and in many scenario the only) contact with the targeted beneficiary. There are many methods currently in use for point of care testing for hemoglobin estimation and include manual methods like Sahli’s method, Indirect cyanmethemoglobin method, WHO Hemoglobin Color Scale method; digital hemoglobinometers including the newer non-invasive devices. The current background paper reviewed available published literature regarding performance of different POCT methods for hemoglobin estimation. Available literature indicates that invasive digital hemoglobinometers have shown a reasonable performance for use as POCT in facility and community settings both for clinical diagnosis as well as surveys. Adequate training of front line workers for use of digital hemoglobinometers and adherence to standard operating procedures (SOPs) is essential to reduce errors/biases. Non-invasive digital hemoglobinometers seem to be promising new option for POCT which obviates the need for drawing blood sample (either by venous or capillary method) but further research and development is required before their use in programs.