Tratamento da anemia ferropriva com medidas não farmacológicas: revisão sistemática e meta-análise

Abstract

Anemia is an important indicator of poor nutrition and health with major consequences for socioeconomic development. According to WHO estimates, between 1993 and 2005, anemia affected approximately a quarter of the world's population, which then corresponded to 1.62 billion people affected, most of them children under the age of four. Among the causes of anemia, iron deficiency is the most common, accounting for 50% of cases. In developing countries such as Brazil, diet is essential for the onset of iron deficiency anemia. The objective is a systematic review and meta-analysis to evaluate the effectiveness of non- pharmacological measures for the treatment of iron-deficiency anemia (IDA). Databases used: MEDLINE (via PubMed), Cochrane library, SciELO/LILACS and EMBASE up to June 2021. We identified all randomized controlled trials (RCTs) that used non-pharmacological measures to treat IDA including iron pots/ingots, or food use were included. The outcomes of interest were hemoglobin (Hb) concentrations and prevalence of anemia. A total of 479 studies were retrieved from the databases, of which 8 duplicate records were removed. After, all titles and abstracts were reviewed, 23 articles were considered potentially relevant, and were read in full and checked for eligibility. Three articles met all inclusion criteria. We also conducted a manual search for citations and a further 8 records were identified and checked for eligibility. Eleven RCTs were included in this review. Estimates showed that the use of non-pharmacological measures was associated with a statistically significant overall increase in mean Hb (MD +0.45 g/dL, 95% CI 0.05 to 0.85, p=0.03). The effect of non- pharmacological measures on the prevalence of IDA was analyzed in only 5 RCTs. Participants in the intervention groups were 2.78 times less likely to suffer from IDA than those in the control groups, OR=2.78, 95% CI 0.93, 8.29, however without significance for the overall effect (p=0.07). Non-pharmacological therapies have a positive effect on iron balance and can a useful adjunct to programs to prevent and treat IDA in at-risk populations. (PROSPERO registration number CRD42021261773).