Hematologic response to iron and ascorbic acid administration in preschool children with anemia

Abstract

The prevalence of anemia was assessed in 1,481 children under 7 years of age in 16 kindergartens and nurseries in an urban and 1,757 preschool children in a remote mountain area. The average prevalence of anemia, defined as hemoglobin level below 11 g/dl, was 8.3% in the entire urban group, 16.5% in those under three years of age, and 35.9% in 7–12 month old infant. For the rural group the figures were 24.2%, 35.1% and 48.8% respectively. The average daily dietary iron intake was estimated to be 8.3 mg in the nurseries and 12.8 mg in the kindergartens in the urban area. A soft drink powder fortified with ferrous sulfate 450 mg and ascorbic acid 270 mg per 100 g was prepared. A child taking 10 g of the powder per day received of 9 mg of elemental iron and 27 mg of ascorbic acid. Thirty-nine anemic children under three years were treated with fortified soft drink powder, 16 for one month and 23 for two months. After treatment, the hemoglobin level, RBC count and hematocrit percentage increased significantly (p<0.001). One hundred and one children under three years of age living at home were similarly treated; 11 were anemic, 17 had hemoglobin value of 11–12 g/dl, 73 had values above 12 g/dl, After three months of treatment, the average hemoglobin concentration increased significantly from 10.1±0.6 to 15.1±1.5 g/dl, from 11.3±0.3 to 15.0±2.2 g/dl and from 12.1±2.5 to 15.3±2.5 g/dl in the three groups respectively. The hematocrit values also showed a highly significant improvement. These observations point to the frequent prevalence of iron-responsive anemia in Chinese preschool children, even among those with initial hemoglobin greater than 12 g/dl.