Evidence map›Paper›PMID 41448804›Full record

Trial reportBMJ global health2025

Impact evaluation of a population-based 'Screen and Treat for Anaemia Reduction (STAR)' strategy: a cluster randomised trial in rural Telangana, India.

Raghu Pullakhandam, Little Flower Augustine, Santosh Kumar Banjara, Teena Dasi, Ravindranadh Palika, Rajesh Majumder, Santu Ghosh, Anju Sinha, Bharati Kulkarni

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Raghu PullakhandamICMR - National Institute of Nutrition, Hyderabad, Telangana, India.ORCID 0000-0002-3758-667X
Little Flower AugustineICMR - National Institute of Nutrition, Hyderabad, Telangana, India.ORCID 0000-0002-2918-7943
Santosh Kumar BanjaraICMR - National Institute of Nutrition, Hyderabad, Telangana, India.ORCID 0000-0002-0893-9552
Teena DasiICMR - National Institute of Nutrition, Hyderabad, Telangana, India.ORCID 0000-0001-9115-7414
Ravindranadh PalikaICMR - National Institute of Nutrition, Hyderabad, Telangana, India.ORCID 0000-0002-3797-6272
Rajesh MajumderDivision of Epidemiology and Biostatistics, St John's Research Institute, Bengaluru, India.ORCID 0009-0007-7139-3795
Santu GhoshDepartment of Biostatistics, St John's Medical College, Bengaluru, Karnataka, India.ORCID 0000-0002-9373-9570
Anju SinhaIndian Council of Medical Research, New Delhi, India.ORCID 0000-0002-0830-7723
Bharati KulkarniICMR - National Institute of Nutrition, Hyderabad, Telangana, India dr.bharatikulkarni@gmail.com.ORCID 0000-0003-0636-318X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPopulation level screen and treat approach for anaemia reduction could be beneficial but its feasibility and impact remains to be tested.

methodsThis cluster randomised trial in rural Telangana included 14 clusters randomised (1:1) to either intervention or control arms. A cluster included all participants (6 months to 50 years) served by a frontline health worker. In the intervention arm, participants were screened for anaemia at point of care, using WHO 2011 cut-offs, followed by iron-folic acid (IFA) supplementation as per the national guidelines. The control arm participants were eligible for benefits of an ongoing national programme. The primary outcome was mean difference (MD) in haemoglobin between two arms at 6 months. The trial was registered at CTRI (CTRI/2019/01/016918).

resultsBaseline characteristics of participants in the intervention (n=6131) and control (n=5255) arms were broadly similar. In the intervention arm, 88.6% of eligible participants were screened and intervention was delivered to 97% of participants. There was no difference in population haemoglobin (g/dL) between the arms (MD 0.03, 95% CI -0.06 to 0.12, p=0.464). However, after adjustment for relevant confounders, mean haemoglobin in the intervention arm was significantly higher (MD 0.25 g /dL, 95% CI 0.03 to 0. 48, p=0.028). Anaemia prevalence was lower in the intervention than the control arm in total sample (29.6% vs 32.5%, p=0.002) as well as in adolescent girls (40.7% vs 56.0%, p<0.001) and women of reproductive age (WRA, 52% vs 56.5%, p=0.02). Compliance to IFA (% consumption of prescribed dose) was 32% and 47.5% in those receiving therapeutic and prophylactic doses, respectively.

conclusionThis study demonstrates the feasibility of implementing a population level screen and treat approach. The intervention reduced anaemia prevalence significantly among vulnerable groups, particularly adolescent girls and WRA. Modest improvement in population haemoglobin and anaemia reduction suggests a need for strategies to improve the compliance to IFA. TRIAL REGISTRATION NUMBER: CTRI/2019/01/016918.

Indexed as

AnemiaMass ScreeningRural PopulationAdolescentAdultChildChild, PreschoolFemaleHemoglobinsHumansIndiaInfantMaleMiddle AgedYoung AdultHemoglobinsAnaemiaCluster randomized trialHealth policyPrevention strategiesPublic Health

Identifiers

PMID41448804
PMCPMC12742117

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.