Ferrotherapy Mistakes in Toddlers in Primary Health Care

Abstract

Introduction. 20–30% of the world population suffers from iron deficiency anemia. Despite the availability of diagnostic and therapeutic options, the real medical practice in relation to iron deficiency anemia remains on a suboptimal level. As a result, over the past 20 years there is no significant improvement in the iron deficiency anemia frequency in young children. Objective. To analyze the existing care tactic for toddlers with iron deficiency anemia in a primary care setting and to identify the possible ferrotherapy mistakes. Methods. A retrospective study of 135 3-year-old children with anemia in primary health care. The inclusion criteria was: documented low hemoglobin level as recommended by WHO in at least two sequential complete blood tests. Results. Control complete blood count (CBC) was performed within 6 months of anemia detection in 70.4% cases. However, this control was performed during the optimal time only in 15.6% of cases. In 56.3% of cases the fact of ferrotherapy wasn’t documented. The onset of ferrotherapy after the first episode of low hemoglobin detection was in 19.3% of children. 29.6% of children received treatment with iron supplements in an adequate dose. Only in 11.9% of cases the dose of iron was lower than recommended. 30.4% of children had a relapse of iron deficiency anemia and up to 6% had multiple relapses. The average duration of iron deficiency anemia in children during the first three years of life was 6.4 months. Conclusion. In the majority of cases the therapy of the majority of iron deficiency anemia in toddlers was delayed. The biggest problem is the lack of adequate hemoglobin levels monitoring.