PRAYAS: Individual Patient Data Meta-analysis (IPD-MA) database for Pooled Research and Analysis for Yielding Anemia-free Solutions in India

Anuj Kumar Pandey¹Anju Sinha^2*Ramu Rawat³Ranadip Chowdhury⁴Shivaprasad S Goudar⁵Jitender Nagpal⁶Shrey Desai⁷AVULA LAXMAIAH⁸Kalpana Basany⁹Sadhana Joshi¹⁰Chittaranjan Yajnik¹¹Aparna Mukherjee²Pratibha Dwarkanath¹²PRIYANKA GUPTA BANSAL²Molly Jacob¹³Shinjini Bhatnagar¹⁴Komal Shah¹⁵Debarati Mukherjee¹⁶Amlin Shukla²Raghu Pullakhandam⁸Varsha Dhurde¹⁷Aditi Apte¹¹Rajeev Singh¹⁸Aakriti Gupta¹⁹Yamini Priyanka²Usha Dhingra³Ravi Prakash Upadhyay²⁰Sutapa Bandyopadhyay Neogi¹Manjunath S Somannavar⁵Anirban Mandal⁶Gayatri Desai⁷Shantanu Sengupta²¹Shailendra Dandge⁹Girija Wagh²²Urmila Deshmukh¹¹Gunjan Kumar²Anura Kurpad¹²G.S. Toteja²Nikhitha Mariya John¹³Shailaja Sopory¹⁴Somen Saha¹⁵Giridhara R Babu²³Anandika Suryavanshi²Ravindranadh Palika⁸Archana Patel¹⁷Radhika Nimkar¹¹GAURAV DWIVEDI¹⁸Umesh Kapil¹⁹Dilip Raja²Arup Dutta³Sunita Taneja²⁰Diksha Gautam¹Avinash Kavi⁵Swapnil Rawat⁶Kapilkumar Dave⁷Rajiva Raman²⁴Catherine L. Haggerty²⁵Sanjay Lalwani²²Prachi Phadke¹¹Alka Turuk²Tinku Thomas¹²Neena Bhatia²Manisha Madai Beck¹³Lovejeet Kaur¹⁴Aakansha Shukla¹⁵Deepa R¹⁶LINDSEY LOCKS²⁶Dhiraj Motilal Agarwal¹¹Raja Sriswan⁸Harshpal Singh Sachdev⁶Rounik Talukdar²⁷Sayan Das³Nita Bhandari²⁰Ranjana Singh²⁸Yogesh Kumar S⁵Ramasheesh Yadav⁶PS Reddy²⁵SANJAY GUPTE²⁹S. Rasika Ladkat¹¹Zaozianlungliu Gonmei²Swati Rathore¹³Dharmendra Sharma¹⁴Apurvakumar Pandya¹⁵Yamuna Ana¹⁶Patricia Hibberd²⁶Himangi Lubree¹¹Anwar Basha Dudekula⁸Priti Rishi Lal¹⁹Pearlin Amaan Khan²Aruna Verma³⁰Umesh Charantimath⁵Indrapal I. Meshram⁸Karuna Randhir¹⁰Onkar Deshmukh¹¹Ashok Kumar Roy²Obed John¹³Nolita Dolcy Saldanha³¹Ashish Bavdekar¹¹Raj Kumar³²SHYAM PRAKASH¹⁹Wafaie W. Fawzi³³Sunil Sazawal^34,35

• ¹International Institute of Health Management Research - New Delhi, New Delhi, India
• ²Indian Council of Medical Research, New Delhi, India
• ³Centre for Public Health Kinetics, New Delhi, India
• ⁴Society for Applied Studies, Kolkata, India
• ⁵KLE Academy of Higher Education and Research Deemed to be University, Belagavi, India
• ⁶Sitaram Bhartia Institute of Science and Research, New Delhi, India
• ⁷Society for Education Welfare and Action-Rural, Bharuch, India
• ⁸ICMR - National Institute of Nutrition, Hyderabad, India
• ⁹MediCiti Institute of Medical Sciences, Medchal, India
• ¹⁰Bharati Vidyapeeth (Deemed to be University) Interactive Research School for Health Affairs, Pune, India
• ¹¹KEM Hospital Pune Research Centre, Pune, India
• ¹²St John's Research Institute, Bengaluru, India
• ¹³Christian Medical College Vellore, Vellore, India
• ¹⁴Translational Health Science and Technology Institute, Faridabad, India
• ¹⁵Indian Institute of Public Health Gandhinagar, Gandhinagar, India
• ¹⁶Public Health Foundation of India, New Delhi, India
• ¹⁷Lata Mangeshkar Medical Foundation, Pune, India
• ¹⁸ICMR - Regional Medical Research Centre Gorakhpur, Gorakhpur, India
• ¹⁹All India Institute of Medical Sciences New Delhi, New Delhi, India
• ²⁰Society for Applied Studies, New Delhi, India
• ²¹CSIR Institute of Genomics & Interactive Biology - South Campus, New Delhi, India
• ²²Bharati Hospital and Research Centre, Pune, India
• ²³Qatar University, Doha, Qatar
• ²⁴Banaras Hindu University, Varanasi, India
• ²⁵University of Pittsburgh School of Public Health, Pittsburgh, United States
• ²⁶Boston University, Boston, United States
• ²⁷Ahmedabad University, Ahmedabad, India
• ²⁸Indian Institute of Public Health Delhi, New Delhi, India
• ²⁹Gupte Hospital and Research Centre, Pune, India
• ³⁰Lala Lajpat Rai Memorial Medical College Meerut, Meerut, India
• ³¹Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, United Kingdom
• ³²Baba Raghav Das Medical College, Gorakhpur, India
• ³³Harvard T H Chan School of Public Health Department of Global Health and Population, Boston, United States
• ³⁴Swami Vivekanand Subharti University, Meerut, India
• ³⁵Center for Public Health Kinetics, New Delhi, India

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. Funding : Indian Council of Medical Research (ICMR) [vide letter no. 5/7/Pooled Analysis/ 2023-RCN] Registration: OSF - https://doi.org/10.17605/OSF.IO/6YRXF