Written By: Pavitra Sampath | Updated : April 15, 2015 10:55 PM IST
The Weekly Iron Folic Acid Supplementation Programme for Adolescents was launched on 17thof July this year amidst a lot of fanfare and doubts. The question most people asked was, since this programme has been tried before, will it work this time? The statistics of children and adolescents suffering from anaemia are staggering -- 80% children and 70% pregnant women are afflicted in India.
Anaemia is a condition caused due to the deficiency of iron in the body. Dr Zinal Unadkat, renowned paediatrician and neonatologist says, 'Folic acid is important for a child's proper growth and development both mentally and physically. Most children found lacking in this important element commonly have low immunity and are stunted in height. Most find it difficult to concentrate and frequently fall ill.'
The current news that the children who were given folic acid supplements in Anganwadi schools have taken ill, comes a few days after 31 children died after having tainted midday meals. So what went wrong? Why is the government not able to get it right? Here are a few answers: (Also read: Was the plan doomed to failure?)
Low quality or contaminated tablets?
Dr Zinal says that the most common reason for this could be that the tablets being administered might have been either of low quality or contaminated. News papers reporting the incident have quoted Anuradha Gupta, additional secretary and mission director, National Rural Health Mission (NRHM), saying that the tablets were of fresh stock and had an expiry date of 2015. Clearly, though the tablets were from a 'fresh stock' and had not expired, there is a great possibility of them being tainted. According to PharmaBuzz ,the tablets were provided by HLL Lifecare Limited after the government floated tenders for the same. The programme was first launched in Karnataka.
Was the dosage too high?
Another point of consideration is that the children were given a higher dose than required. Dr Zinal says, ' When we administer any medication to a child, the dosage is decided based on the child's height and weight. In this case I doubt that the children were given a dose that was right for them, individually.' In a country where the population of people needing help is far more than those providing it, a blanket dose could have been administered. Incidentally, the dose for a child should not exceed 500 mg.
According to the FDA's information about folic acid supplements, an overdose can cause symptoms such as vomiting, diarrhoea, confusion, dizziness, abdominal cramps and general malaise symptoms that all the children experienced.
Could Vitamin B 12 deficiency be the cause?
Another reason for the mishap could be that the children were B12 deficient. One of the most common reactions of folic acid occurs when a child is deficient in B12 and is administered folic acid without any consideration for the deficiency. This leads to severe symptoms manifesting in the child. According to Dr Zinal , ' We did a study where we found that 30-40% of the children tested were vitamin B12 deficient. It was also found that most vegetarians are deficient in the vitamin while non vegetarians are not. Although this could be a likely cause, it is difficult to test every child for the deficiency.'
An uncommon reason for this drastic reaction to the folic acid tablets could be haemolysis (a condition where blood leaks out of the blood vessels leading to hemorrhaging).
Amidst speculation about the cause for this adverse reaction in the children, and government officials deeming it as an uncommon side effect with no need to panic, we await some much needed answers.
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