ArticleFrontiers in public health2025
PRAYAS: individual patient data meta-analysis database for Pooled Research and Analysis for Yielding Anemia-free Solutions in India.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The PRAYAS Individual Patient Data Meta-analysis (IPD-MA) database aims to estimate the prevalence of anemia among children under 18 years, non-pregnant and non-lactating (NPNL) women, and pregnant women (by trimester), with further stratification by age group, year, and region of India. Beyond prevalence, it seeks to address the etiological contribution of iron and other erythropoietic micronutrient deficiencies and to evaluate the effectiveness of anemia prevention and treatment interventions, including factors associated with non-response. This will directly support India's "test-treat-track" approach under the Anemia Mukt Bharat program. Participants: Children (0-18 years), pregnant women, and NPNL women in India. Findings to date: The database currently includes 88 datasets (1994-2023), with 319,721 participants for prevalence analysis-children (19,762), NPNL women (17,883), and pregnant women (282,076). Intervention studies comprise 59,292 participants-children (13,435), NPNL women (11,594), and pregnant women (34,263). Over half the datasets (55.7%, 49/88) are randomized controlled trials, while 35.2% (31/88) are observational. Geographically, 43.2% (38/88) are from northern India, 22.7% (20/88) from the west, and 18.2% (16/88) from the south. Most studies (67%, 59/88) are community-based. Median ages were 26 years (IQR 23-32) for NPNL and 23 years (IQR 21-25) for pregnant women, while children's data covered 6 months to 18 years. Mean gestational age at enrollment in pregnancy was 10.24 weeks (SD 17.65). Of the total sample, 10.8% had complete blood count data, 9% ferritin, and 4.5% vitamin B12.Among interventions, pregnant women received intravenous iron sucrose, ferric carboxymaltose, iron isomaltoside, combined IV iron with vitamin B12/folic acid/niacinamide, integrated packages, and low-dose calcium supplementation. NPNL women were often part of trials comparing 60 mg daily ferrous sulfate with 120 mg on alternate days. Children's interventions mainly included ferrous sulfate, food supplementation, and select Ayush-based approaches. Future plans: PRAYAS will generate robust, policy-relevant evidence to refine anemia prevention and treatment strategies. Findings will directly inform the Anemia Mukt Bharat program, supporting targeted, evidence-driven interventions to reduce anemia and associated health burdens across children, women, and pregnant populations in India. Clinical Trial Registration: OSF-https://doi.org/10.17605/OSF.IO/6YRXF.
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