Haematological and Peripheral Blood Smear Response to Two Months of Oral Iron Therapy in Anaemic Adult Females: A Paired Study from West Tripura, India

Abstract

Background: Anaemia is a common health problem among women of reproductive age. Local studies from Tripura have reported anaemia in young women and have highlighted the possible contribution of menstrual and nutritional factors. This study evaluated haematological parameters and peripheral blood smear findings in anaemic adult females before and after oral iron therapy. Methods: This prospective paired study was conducted in West Tripura, India, from April to July 2026. Sixty anaemic adult females aged 20–45 years and 12 healthy female controls were evaluated. Fifteen of the 60 anaemic participants completed two months of prescribed oral iron therapy and underwent repeat testing; therefore, treatment-response analysis was restricted to these 15 participants. Haemoglobin, red blood cell count, packed cell volume, mean corpuscular volume, mean corpuscular haemoglobin, and mean corpuscular haemoglobin concentration were measured using an automated haematology analyser. Peripheral blood smears were stained with Leishman stain and examined microscopically. Ferritin/iron-profile investigations and reticulocyte counts were not performed. Results: At baseline, anaemic participants had lower haemoglobin, red blood cell count, packed cell volume, and red cell indices than healthy controls. Among the 15 participants who completed follow-up, mean haemoglobin increased from 10.56 ± 0.31 g/dL to 12.37 ± 0.25 g/dL (p < 0.001). Red blood cell count, packed cell volume, mean corpuscular volume, and mean corpuscular haemoglobin also improved significantly. The change in mean corpuscular haemoglobin concentration was not statistically significant (p = 0.684). Peripheral blood smears showed qualitative improvement in red cell morphology after treatment. Because only 15 participants completed follow-up, these treatment-response findings are preliminary and should not be generalised to all 60 anaemic participants. Conclusion: In the 15 anaemic participants who completed two months of follow-up, oral iron therapy was associated with significant improvement in most measured haematological parameters and qualitative improvement in peripheral smear morphology. The findings should be interpreted cautiously because of the small paired sample, substantial loss to follow-up, absence of biochemical iron studies and reticulocyte counts, incomplete information on the treatment regimen, and lack of an untreated comparison group.