Treatment of Severe Iron‐deficiency Anaemia of Hookworm Infestation with Ferastral®, a new Intramuscular Iron Preparation

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Abstract
Thirty Nigerians with severe iron‐deficiency anaemia were treated with iron‐poly (sorbitol‐gluconic acid) complex (Ferastral®), which allows 500 mg iron to be given in one intramuscular injection. Two dose schedules were tried: A, eight patients received Ferastral 5 ml (250 mg iron) and B, 22 patients 10 ml (500 mg iron) on alternate days. Supportive treatment included prophylactic antimalarials and folic acid supplements for three weeks. Initial haemoglobin (Hb)‐concentrations were 1.7–7.6 g/100 ml; total dose of iron required was 1 496–3 500 mg.No patient complained of undue pain at injection site or other side‐effects. There was no evidence of hepatic or renal toxicity after four weeks in 18 patients and eight weeks in 11 patients.Average daily Hb‐regeneration in the first two weeks on schedule A was 0.26 g/100 ml and schedule B 0.33 g/100 ml. Mean daily regeneration in patients with initial Hb < 3.6 g/100 ml was 0.30 g/100 ml, while in those with Hb > 5.5 g/100 ml it was 0.25 g/100 ml. All haematological indices returned to normal by eight weeks, except in three patients with minimally reduced MCH and three other patients in whom there was persistent anaemia due to blood loss, only one of whom was again sideropenic. Bephenium hydroxynaphthoate was found to be ineffective and tetrachloroethylene highly effective in the treatment of hookworm.Ease of administration, lack of side reactions and effectiveness of Ferastral represent a therapeutic advance of value in rural tropical areas.