High Prevalence Of Iron Deficiency Anemia Research Articles

A Multicenter Retrospective Chart Review Study Estimating the Prevalence of Iron Deficiency Anemia Among Infants, Toddlers, and Children in Riyadh, Saudi Arabia.

Background Iron deficiency anemia (IDA) is a prevalent nutritional disorder affecting children worldwide, leading to potential long-term cognitive and developmental deficits. This study aimed to determine the prevalence of IDA among healthy children attending Dr. Sulaiman Al-Habib Hospital Group in Riyadh, SAU, and explore the relationship between IDA and various demographic factors, including age, gender, and nationality. Methodology A retrospective chart review was conducted from July 2023 to August 2023 at Dr. Sulaiman Al-Habib Hospital Group, in Riyadh, Saudi Arabia. The study included 498 children aged 0.58 to 17 years, selected through a cluster sampling technique. Data on demographic characteristics and laboratory results, including hemoglobin (Hb) levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), ferritin, and RBC, were collected. Iron deficiency anemia was diagnosed based on Hb levels and other hematological indices. Statistical analysis was performed using SPSS Statistics version 23.0 (IBM Corp., Armonk, NY, USA). Results The prevalence of IDA among the study population was 9.2%, with 72.3% of the cases classified as mild and 27.7% as moderate. No cases of severe anemia were found. Infants had the highest prevalence of IDA (16.9%), followed by toddlers (12.0%), preschool children (7.2%), and school-age children (0.8%). Gender analysis revealed a prevalence of 9.7% in males and 8.6% in females, with no significant difference between genders (p = 0.659). All non-Saudi participants were free of IDA, whereas 9.3% of Saudi participants had IDA, though this difference was not statistically significant (p = 0.761). Conclusion The study found a relatively low prevalence of IDA among healthy children attending Dr. Sulaiman Al-Habib Hospital Group in Riyadh, SAU, with the highest prevalence observed among infants. These findings highlight the need for targeted interventions to prevent IDA, particularly in younger children. Routine screening and early treatment are crucial to mitigate the potential long-term effects of IDA on child development. Further research with larger and more diverse samples is recommended to validate these findings and explore additional factors influencing IDA prevalence.

Iron Insights: Exploring Age-Specific Variations In Anaemia Prevalence In Islamabad

Background & Introduction: Blood, a specialized connective tissue, facilitates the vital transport of oxygen, carbon dioxide, minerals, hormones, and salts throughout the body. Anemia, characterized by reduced oxygen-carrying capacity, often stems from factors such as diminished red blood cell (RBC) synthesis or excessive blood loss. Notably, iron deficiency stands out as a prominent cause, particularly among females of reproductive age, due to factors like inadequate dietary iron intake and menstrual blood loss. Objectives: This study aims to assess the prevalence of iron deficiency anemia (IDA) in both males and females across different age groups. Specifically, we seek to determine the frequency of IDA and its distribution among age cohorts spanning 6-12 years, 13-19 years, and 20-50 years. Methodology: Employing a cross-sectional study design, we surveyed a population of 2071 individuals, selecting a sample of 3[1]24 participants through non-probability convenient sampling methods. Descriptive statistics, facilitated by SPSS, guided our analysis. Hematological parameters including hemoglobin (HB) levels, RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were evaluated to ascertain the hematological status of the study cohort. Results: Our findings reveal notable trends in IDA prevalence across age groups. Among participants aged 16-30 years, IDA incidence stood at 51%, whereas the 31-35 years age group exhibited a 26% prevalence, and the 46-60 years age group recorded a 23% incidence of IDA. Additionally, our analysis indicates a higher prevalence of IDA among females, constituting 65% of all IDA cases, particularly pronounced in the reproductive age bracket of 16-30 years. Conclusion: The study underscores a gender-based discrepancy in IDA prevalence, with females exhibiting a higher incidence compared to males. Notably, females within the reproductive age range of 16-30 years emerge as a particularly vulnerable demographic. These findings emphasize the importance of targeted interventions to address iron deficiency, especially among at-risk populations.

Impact of iron supplementation on patient outcomes for women with abnormal uterine bleeding: a protocol for a systematic review and meta-analysis

BackgroundAbnormal uterine bleeding (AUB), which includes heavy menstrual bleeding (HMB), is a common condition placing women at increased risk for developing iron deficiency and iron deficiency anemia (IDA). Depletion of iron stores has negative implications on physical, social, and emotional health, as well as quality of life. Iron supplements are safe, effective, and readily available, while red blood cell (RBC) transfusions have inherent risks including infectious and immune reactions. Despite high prevalence of IDA among women with AUB, there are limited studies on the impact of iron therapies on patient outcomes. This systematic review and meta-analysis will evaluate the impact of iron supplementation on patient outcomes for women with AUB, when compared to combination therapy, no intervention, placebo, or standard of care.MethodsWe will conduct a systematic review and meta-analysis of randomized controlled trials and observational studies evaluating the impact of iron interventions on patient outcomes for women with AUB. Systematic literature searches will be conducted in major databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and Web of Science. Studies assessing the impact of iron interventions on patient outcomes in women experiencing AUB, in comparison to combination therapy, no intervention, placebo, or standard of care, will be included in the review. Independent reviewers will screen for eligibility, assess risk of bias, and abstract data. Overall certainty of evidence for each outcome will be assessed using the GRADE approach. We will meta-analyze outcomes which are sufficiently homogeneous to summarize intervention effects and narratively synthesize nonhomogeneous outcomes. The main outcomes of interest are hemoglobin levels immediately prior to surgery and post-operatively, number of RBC transfusions, and adverse effects. Secondary outcomes will include length of hospital stay, intraoperative blood loss, adverse and side effects, quality of life, and iron indices.DiscussionThis review will evaluate the impact of iron interventions on patient outcomes in women with IDA secondary to AUB with focus on changes in hematological and iron indices, red blood cell utilization, quality of life, cost of treatment, and adverse events. The results will inform evidence-based clinical practice for the management of iron deficiency and IDA secondary to AUB.Systematic review registrationPROSPERO CRD42019137282.

Examining the Prevalence of Iron-deficiency Anemia in Children with Cyanotic Congenital Heart Disease Admitted to the Pediatric Heart Department of Imam Reza Hospital in Mashhad between 2011 and 2019: A Cross-sectional Observational Study

Introduction: This study was performed to investigate the frequency of iron-deficiency anemia and some related factors in children with cyanotic congenital heart disease between 2011 and 2019 in Mashhad City, Iran. Method: This cross-sectional observational study was conducted with a consensus method on children under 14 years of age. The samples were diagnosed with cyanotic congenital heart disease in the pediatric heart department of Imam Reza Hospital in Mashhad and had an oxygen saturation of less than 94%. The information from the patients' files was recorded in the questionnaire. The studied children were divided into five age groups to evaluate iron-deficiency anemia. The mean and lower limit of normal erythrocyte indices were determined, and the patients with anemia were identified based on mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), and red blood cell distribution width (RDW). The data were statistically analyzed in SPSS23 software using Chi-square and Mann-Whitney statistical tests. A significance level of 0.05 was considered. Results: Among 250 examined patients, 90 cases were included in the study (54 boys and 36 girls). Angiography was the reason for half of these patients' referral to the hospital. The highest frequency was related to patients with tetralogy of Fallot (40%). The frequency rates of iron-deficiency anemia based on MCV and MCH erythrocyte indices were 10% and 17.8%, respectively. Moreover, 64.4% of patients had increased RDW levels. Cyanosis attacks were reported positive in 85.4% of the studied population. Of note, the frequency of cyanosis attacks was not significantly different in the two gender groups (P<0.494). Conclusion: Considering the high prevalence of iron-deficiency anemia, especially in children with congenital heart disease, the treatment of this disorder is necessary for all such children and should not be neglected

Minimum Dietary Diversity-Women Score, a Key Indicator of Micronutrient Adequacy and its Association with Iron Status among Pregnant Women: Evidence from a Hospital-Based Cross-Sectional Study

A diversified diet is crucial for micronutrient adequacy in a pregnant woman. Iron deficiency Anemia (IDA) is linked to a lack of diversity in diets. The Minimum Dietary Diversity-Women (MDD-W) is a global indicator developed by the FAO to assess diet quality among women of reproductive age. The study seeks to determine the prevalence of MDD scores and its association with sociodemographic factors and iron status among pregnant women. Hospital-based cross-sectional study was conducted among pregnant women at the women’s hospital, Prayagraj, Uttar Pradesh using systematic sampling frame. An enumerator-administered semi-structured interview schedule was used. Hemoglobin levels were assessed and IDA categorized. The prevalence of anemia was 47.4%, of which only 18.1% of women consumed a diverse diet and 81.89% had low MDD-W scores. The mean hemoglobin was 10.82 g/dl, Standard deviation 1.58. Socioeconomic status showed significant correlation to anemia (P = 0.001), and an OR of 1.099 at 95% confidence interval. The high prevalence of IDA and low MDD-W scores proves the need for increased awareness on dietary diversity rates among pregnant women so that micronutrient adequacy can be achieved.

IRON DEFICIENCY ANAEMIA IN PREGNANCY: A REVIEW

India’s high prevalence of iron-deficiency anaemia is primarily due to the vegetarian diet in women. Malnutrition is due to low economic condition, generally poor nutrition, insufficient protein & iron diet, inadequate iron absorption, and expanded requirements. Adopting this lower level, anemia in pregnancy ranges widely from 40 to 80% in the tropics compared to 10 to 20% in developed countries. Anaemia is responsible for 20% of maternal deaths in third world countries. Approximately 51% of pregnant women are anaemic. Of all anemias diagnosed during pregnancy, 75% are due to iron deficiency.

Red cell distribution width as a differential parameter between iron deficiency anemia and a-thalassemia: an empirical approach

Iron deficiency anemia (IDA) and thalassemia minor are the most common hypochromic microcytic anemias in the world. Different formulas have been proposed to differentiate IDA from beta thalassemia minor. However, yet no formula has been proposed to differentiate IDA from alpha thalassemia minor, and Hb electrophoresis is not helpful in this hemoglobinopathy. Red cell distribution width (RDW) as indicator of changes in red blood cell size is primarily employed to differentiate IDA from other microcytic anemias. An empirical approach involving iron therapy over 1 month has shown that an increase in Hb concentration by 1 g/dL over this period is indicative of IDA, while no changes in Hb concentration are suggestive of alpha thalassemia. RDW measured after iron therapy in order to differentiate IDA and related disorders from alpha thalassemia is a better index than an increased reticulocyte count. Due to the high prevalence of IDA and costly and time-consuming nature of specific diagnostic tests, the RDW index is considered as a very sensitive and cost-effective tool in the differential diagnosis of IDA.

Socio-economic status, iron deficiency anemia and COVID-19 disease burden – an appraisal

Introduction. Severe Acute Respiratory Syndrome-2, possesses varying degrees of susceptibility and lethality worldwide and WHO declared this as a pandemic of this century. Aim. In this background, the aim of this present narrative is to provide a complementary overview of how low iron stores and mild anemia offers protection from infectious diseases like COVID-19 by restricting the viral replication and also to suggest some potential adjuvant therapeutic interventions. Material and methods. Therefore, we performed a literature search reviewing pertinent articles and documents. PubMed, Google Scholar, Chemrxiv, MedRxiv, BioRxiv, Preprints and ResearchGate were investigated. Analysis of the literature. Recent studies reported drastic systemic events taking place that contribute to the severe clinical outcomes such as decreased hemoglobin indicating anemia, hypoxia, altered iron metabolism, hypercoagulability, oxidative stress, cytokine storm, hyper-ferritinemia and thus Multi Organ Failure, reportedly hailed as the hallmark of the COVID-19 hyper- inflammatory state. Interestingly it is globally observed that, countries with higher Socio-economic status (SES) have considerably lower prevalence of Iron Deficiency Anemia (IDA) but higher Case Fatality Rate (CFR) rate due to COVID-19 while, low SES countries characterized by the higher prevalence of IDA, are less affected to COVID-19 infection and found to have less CFR, which is almost half to that of the higher SES counterpart. Conclusion. Present review presumed that,low iron stores and mild anemia may play a beneficial role in some cases by offering protection from infectious diseases as low iron restricts the viral replication.Thus, suggested iron chelation or iron sequestration as an alternative beneficial adjuvant in treating COVID-19 infection.

Ferric Carboxymaltose Solution Versus Iron Sucrose Complex in Treating Iron-Deficiency Anemia Patients with Heavy Uterine Bleeding

BACKGROUND: Heavy uterine bleeding (HUB) affects 4.0%–51.6% of women and is responsible for the high prevalence of iron-deficiency anemia (IDA). Ferric carboxymaltose (FCM) is a novel Type I polynuclear iron (III)-hydroxide carbohydrate complex that is highly stable and requires short administration time. The current study estimated the budgetary impact of adopting FCM to treat IDA in HUB patients from the perspective of a tertiary care hospital in the Kingdom of Saudi Arabia (KSA). SUBJECTS AND METHODS: A budget impact model was adopted to compare the total annual costs of iron sucrose complex (ISC) versus FCM from a tertiary care hospital setting perspective in a 1-year time horizon. RESULTS: The total annual cost in ”ISC” scenario was higher than in ”FCM” scenario (Saudi Riyal [SAR] 1,079,535 vs. SAR 724,981), resulting in a cost saving of SAR 355,000 over a 1-year time horizon with FCM. Lower expenditure on health professionals and lower costs of disposables and overhead were the main drivers to the cost savings accounting for nearly 96% of the savings. Although the direct IV iron cost was higher in ”FCM” scenario, the increase in pharmaceutical drug cost was offset by the savings in the cost associated with disposables (−SAR 232,000) and resource utilization (−SAR 451,195). CONCLUSION: FCM was associated with cost savings as compared to ISC for the treatment of IDA in HUB patients from the tertiary care hospital perspective in the KSA.

Traumatic Bleeding in Mice Is Amplified By Iron Deficiency Anemia and Can be Mitigated By Tranexamic Acid Prophylaxis

Iron deficiency is the most common nutritional disorder worldwide, often resulting in severe anemia. At highest risk are children and pregnant women in developing countries where maternal mortality is very high (~500-1000 per 100,000 births) compared to developed countries (~5-10 per 100,000 births). Postpartum hemorrhage (PPH), defined as 500 -1000 mL of blood loss, is responsible for 30 - 50% of the deaths. Clinical evidence suggests that anemia increases the risk of PPH, which is associated with poor outcomes. These observations have large implications in areas like Sub-Saharan Africa, where the prevalence of iron deficiency anemia (IDA) approaches 80%. To study the effects of IDA on traumatic bleeding we developed a mouse model of IDA and traumatic injury, and tested the utility of prophylactic tranexamic acid (TXA) to mitigate bleeding. TXA is an anti-fibrinolytic agent that can be administered orally or intravenously, and reduces mortality when given shortly after trauma or PPH. Materials and Methods First, we generated mice with severe IDA. Different groups of C57BL/6J mice, both male and female, were subjected to three different diets starting at 3 weeks of age: "iron deficient diet" (4ppm iron), "standard iron diet" (48ppm iron) and usual laboratory chow. After 6 weeks, a complete blood count (CBC) was performed to document the degree of anemia and red cell indices and mice were subjected to an established liver laceration model causing severe bleeding. In some groups of mice, TXA or saline were administrated as bolus (10mg/kg) before liver laceration. Blood loss was assessed by weighing blood-soaked sponges in the abdominal cavity 10 minutes after injury. All data were expressed as mean ± SD and were compared using non-parametric Kruskal-Wallis one-way ANOVA or Mann-Whitney test. Results Only mice fed with the "iron deficient diet" developed hypochromic and microcytic anemia with a mean hematocrit of 32±1.7%. The hematocrit of mice fed with the "standard iron diet" or usual laboratory chow (control groups) was within normal range and similar (49±1.2%). Mice with IDA subjected to liver laceration demonstrated significantly increased bleeding when compared to the control groups. Blood loss in mice with IDA was 0.50±0.01g compared to ~ 0.40±0.01g in the control groups (p<0.0001). Prophylactic treatment with TXA reduced bleeding significantly in all groups of mice to ~ 0.33±0.01g (p<0.0001), demonstrating that TXA controlled bleeding similarly in anemic and non-anemic mice. Conclusion IDA causes enhanced bleeding in a murine trauma model which was mitigated significantly by administration of prophylactic TXA. While the mechanisms by which IDA increases traumatic bleeding are not well defined, our observations point towards a pragmatic, prophylactic role of TXA in areas with a high prevalence of IDA (i.e. Sub-Saharan Africa) and high mortality associated with potentially preventable bleeding situations like PPH. In fact, a clinical trial to test this hypothesis is currently ongoing (Women-2; https://clinicaltrials.gov/ct2/show/NCT03475342). It is in this context that our mouse model could be utilized to study the etiology, treatments and outcomes of augmented traumatic bleeding in IDA, the most prevalent cause of anemia in the developing world. Disclosures von Drygalski: Biomarin, Bioverativ/Sanofi-Genzyme, Novo Nordisk, Pfizer, Uniqure, Takeda: Consultancy; Hematherix Inc: Membership on an entity's Board of Directors or advisory committees, Other: Cofounder; superFVa; Joint Activity and Damage Examination (JADE) Ultrasound measurement tool: Patents & Royalties.

Portal hypertensive gastropathy is associated with iron deficiency anemia.

SummaryBackground and aimsPortal hypertensive gastropathy (PHG) is common in patients with cirrhosis and may cause bleeding. This study systematically explored the independent impact of patient characteristics, portal hypertension and hepatic dysfunction on PHG severity and associated anemia.MethodsPatients with cirrhosis undergoing endoscopy were included in this retrospective analysis and PHG was endoscopically graded as absent, mild or severe. Clinical and laboratory parameters and hepatic venous pressure gradient (HVPG) were assessed with respect to an association with severity of PHG.ResultsA total of 110 patients (mean age: 57 years, 69% male) with mostly alcoholic liver disease (49%) or viral hepatitis (30%) were included: 15 (13.6%) patients had no PHG, 59 (53.6%) had mild PHG, and 36 (32.7%) had severe PHG. Severe PHG was significantly associated with male sex (83.3% vs. 62.2% in no or mild PHG; p = 0.024) and higher Child-Turcotte-Pugh (CTP) stage (CTP-C: 38.9% vs. 27.0% in no or mild PHG; p = 0.030), while MELD was similar (p = 0.253). Patients with severe PHG had significantly lower hemoglobin values (11.2 ± 0.4 g/dL vs. 12.4 ± 0.2 g/dL; p = 0.008) and a higher prevalence of iron-deficiency anemia (IDA: 48.5% vs. 26.9%; p = 0.032). Interestingly, HVPG was not significantly higher in severe PHG (median 20 mm Hg) vs. mild PHG (19 mm Hg) and no PHG (18 mm Hg; p = 0.252). On multivariate analysis, CTP score (odds ratio, OR: 1.25, 95% confidence interval, CI 1.02–1.53; p = 0.033) was independently associated with severe PHG, while only a trend towards an independent association with IDA was observed (OR: 2.28, 95% CI 0.91–5.72; p = 0.078).ConclusionThe CTP score but not HVPG or MELD were risk factors for severe PHG. Importantly, anemia and especially IDA are significantly more common in patients with severe PHG.Electronic supplementary materialThe online version of this article (10.1007/s00508-019-01593-w) contains supplementary material, which is available to authorized users.

Caregivers' knowledge and perception of iron content in common staple foods consumed in Southeastern Nigeria

Background: Iron-deficiency anemia remains a major cause of morbidity and mortality of children in our environment. The knowledge of its function and food-rich sources of iron among mothers and/or caregivers will go a long way to mitigate the growth and developmental consequences of iron deficiency in children. Methods: Due to the high prevalence of iron-deficiency anemia in our locality, we set out to determine the knowledge of mothers and/or caregivers of the richest source of iron among all staple foods commonly consumed in our locality and their awareness of cooking methods that degrade the dietary iron. This cross-sectional hospital study conducted over an 8-month period recruited and interviewed 407 mothers/caregivers attending the Children's Outpatient Clinic of the Enugu State University Teaching Hospital using illustrated self-administered questionnaires. Results: A vast majority (90.9%) were aware of dietary iron, but when further questioned about its source and function, almost all respondents (99.2%) considered unripe plantain as the richest food source of iron. None chose cowpea which contains the highest iron content. Likewise, none identified cooking practices that reduce dietary iron availability. Eighteen (4.4%) correctly recognized individuals at the highest risk for iron deficiency, whereas only 5 (2.4%) and 1 (0.3%), respectively, correctly selected all the correct functions of iron and ways it can be lost in the body. Conclusion: Respondents in our study have absolutely no knowledge of cowpea, the richest and cheapest sources of iron in our environment. There is consequently a need to create a comprehensive nutritional campaign, especially during antenatal and well-child clinic visits, to educate parents/caregivers on local and readily available iron-rich food sources and cooking practices while discouraging cooking practices that could potentially degrade elemental iron in these food sources.

Functional properties of mouse ferroportin, a cellular iron‐export protein

Iron homeostasis is a topic of great public‐health importance because of the high prevalence of iron‐deficiency anemia and of hereditary disorders that cause iron overload. Ferroportin (Fpn)—the only known mammalian cellular iron exporter—is expressed on the plasma membrane of macrophages, enterocytes, and hepatocytes. Fpn, under the control of the iron‐regulatory hormone hepcidin, serves a critical role in the regulation of systemic iron. Whereas we have previously characterized the functional properties of human Fpn, a great deal of research in iron homeostasis utilizes mouse models, highlighting the need to study mouse Fpn in vitro. For example, the flatiron mouse model of classical ferroportin disease bears the mutation H32R in mFpn and is characterized by systemic iron deficiency and macrophage iron loading. The flatiron mouse also appears to exhibit a manganese phenotype [Seo YA and Wessling‐Resnick M (2015) FASEB J 28, 2726–2733], raising the possibility that mouse Fpn (mFpn) serves a role in Mn metabolism, although Mn is not a substrate of human Fpn. We therefore tested the hypothesis that mouse but not human Fpn can transport Mn. We characterized the functional properties of mFpn by using radiotracer assays in RNA‐injected Xenopus oocytes expressing mouse or human Fpn. We found that mFpn can export several transition metals, with selectivity Fe > Co > Ni, but not Cd. Whereas the H32R mutant abolished mFpn‐mediated Fe efflux relative to wildtype, neither wildtype nor mutant mFpn could transport Mn. mFpn‐mediated Fe efflux was pH‐dependent with estimated optimal pH of 8.2 ± (SEM) 0.2 when [Ca2+]o = 2 mM. mFpn‐mediated Fe efflux was activated by extracellular Ca2+, proceeded independently of extracellular Na+, and was inhibited 51% ± 1% by 10 μM hepcidin (30‐min preincubation). Our data (i) reveal that human and mouse Fpn share similar functional properties and (ii) do not support the notion that Fpn can transport Mn.Support or Funding InformationNIH grants R01 DK107309, P30 DK078392, and R25 HL115473, and the American Physiological SocietyThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Assessment of iron deficiency in malnutrition: the value of serum ferritin

Background Iron deficiency is the most common micronutrient deficiency seen in protein energy malnutrition (PEM) and a common cause of morbidity and mortality in this condition. Aim The aim of the study was to assess the value of serum ferritin among PEM patients with iron deficiency. Patients and methods It was a case–control study in which the participants were children diagnosed of PEM and the controls were children with normal nutrition. Ninety participants and controls each participated in the study with informed consent obtained from caregivers. Full blood count and examination of peripheral blood smear and serum ferritin concentration was analyzed by enzyme-linked immunosorbent assay. Statistical analysis Data entry and analysis were carried out with a microcomputer using the SPSS, version 16, software packages. Results The mean age of the children with PEM was 22.7±14.4 months. In the participants, the prevalence of iron deficiency was 24.4%, while that of iron-deficiency anemia was 16.6%. The mean serum ferritin levels were significantly lower in the patients compared with controls (P=0.000). The sensitivity and specificity of serum ferritin was 100.0% (95% confidence interval). The likelihood ratio was 0.00 (95% confidence interval). Conclusion Patients with PEM were found to have high prevalence of iron-deficiency anemia and low serum ferritin levels. The sensitivity and specificity of serum ferritin levels were found to be high among PEM patients with iron-deficiency anemia.

Recognizing missed opportunities to diagnose and treat iron deficiency anemia: A study based on prevalence of anemia among children in a teaching hospital.

Background:In developing world, anemia is a significant cause of mortality and morbidity in children under 5 years of age. Iron deficiency anemia (IDA) is a very important causative factor for childhood anemia. The aim of this study was to find the prevalence of anemia in different age group, sex, and its pattern of severity in hospitalized children.Materials and Methods:A cross-sectional study was carried out in a teaching hospital in Kolkata between April 2016 and September 2016. Children 1–168 months of age were included in the study.Results:Of 697 children, 296 (42.5%) had anemia as per the World Health Organization criteria. Males outnumbered the females with a ratio of 1.6:1. The median age of presentation was 29.6 months. The majority were from 1–5 years of age. About 73.3% of children had moderate anemia, whereas 21.3% had severe anemia and only 5% had mild anemia. The mean hemoglobin, mean mean corpuscular volume, mean mean corpuscular hemoglobin concentration, and mean red cell distribution width were 9.3 ± 1.4 g/dL, 73.6 ± 8.8 (fL), 32.2 ± 2.6, and 16.3 ± 3.4 (%), respectively. Microcytic hypochromic anemia (71.3%) was the most common morphological type in all age groups, whereas macrocytic anemia was the least common among them. Prevalence of IDA was 69%. IDA was documented in close to 80% of children with microcytic hypochromic anemia. Interestingly, IDA was also documented in almost half of the children with normocytic normochromic anemia.Conclusion:The high prevalence of IDA among these hospitalized children indicates the role of early screening for IDA in all children with anemia. This early diagnosis and prompt management can prevent the mortality and morbidity related to IDA.

Prevalence and risk factors of iron-deficiency anemia in Saudi female medical students

Introduction: Iron-deficiency anemia (IDA) is quite common in female adolescents and adults worldwide. Despite the higher prevalence of IDA, there is a paucity of research in finding its prevalence and potential causes in young Saudi female population. Thus, the aim of this study was to determine the prevalence and possible causes of IDA in young female medical students and search for risk factors in the studied group. Materials and Methods: One hundred and twenty female students from Imam Abdulrahman Bin Faisal University were selected by randomized sampling whose blood samples were taken to measure their hemoglobin (Hb) and serum ferritin levels. According to the World Health Organization criteria, individuals with Hb 0.05) was found between IDA and the background, gynecological history, and dietary habits of the anemic participants. Conclusions: The higher prevalence rate of anemia among Saudi female medical students (38.3%) was similar to the earlier reports of the Gulf region. Considering the higher ratio of anemic students, iron supplements should be prescribed to the affected youngsters to improve their Hb level.

Prevalencia de anemia ferropénica en deportistas seleccionados del Instituto Peruano del Deporte durante el año 2013: estudio transversal

Introducción: El objetivo de este trabajo fue determinar la prevalencia de anemia ferropénica según el componente dinámico y estático, identificando de esta manera los deportes con mayor prevalencia de anemia y determinar la asociación entre el sexo, la edad y anemia.Material y métodos: Estudio observacional de tipo corte transversal analítico. Se utilizó la base de datos de la Dirección Nacional de Servicios Biomédicos del Instituto Peruano del Deporte, en el periodo de enero a diciembre de 2013. De un universo de 1833 deportistas, se seleccionaron aquellos entre 18 y 35 años de edad. Las variables numéricas se evaluaron usando la prueba de t de Student o la prueba de Mann-Whitney dependiendo del estado de normalidad de las variables. Las variables categóricas fueron evaluadas usando χ2. Razones de prevalencias crudas y ajustadas fueron calculadas usando regresión de Poisson con varianza robusta, para evaluar la asociación entre sexo y anemia.Resultados: Se analizaron 633 deportistas, siendo en su mayoría varones (68,4%). Las variables que se incluyeron en el modelo bivariado fueron sexo, edad deportiva y suplementación con hierro, las cuales fueron también incluidas en el modelo multivariado, encontrándose asociación entre anemia y edad deportiva (p=0,01). No se encontró asociación entre sexo y anemia (RPa= 0,96; IC95%: 0,60-1,40; p=0,85), sin embargo, la prevalencia de anemia fue por encima del 15% (17,9% hombres y 16,8% mujeres).Conclusiones: Se halló mayor prevalencia de anemia ferropénica en los deportes de alto componente estático y dinámico. No se encontró asociación entre anemia ferropénica y sexo en deportistas seleccionados del Instituto Peruano del Deporte en el año 2013.

Efficacy of iron-supplement bars to reduce anemia in urban Indian women: a cluster-randomized controlled trial ,

Background: India's high prevalence of iron-deficiency anemia has largely been attributed to the local diet consisting of nonheme iron, which has lower absorption than that of heme iron.Objective: We assessed the efficacy of the consumption of iron-supplement bars in raising hemoglobin concentrations and hematocrit percentages in anemic (hemoglobin concentration <12 g/dL) Indian women of reproductive age.Design: The Let's be Well Red study was a 90-d, pair-matched, cluster-randomized controlled trial. A total of 361 nonpregnant women (age 18-35 y) were recruited from 10 sites within Mumbai and Navi Mumbai, India. All participants received anemia education and a complete blood count (CBC). Random assignment of anemic participants to intervention and control arms occurred within 5 matched site-pairs. Intervention participants received 1 iron-supplement bar (containing 14 mg Fe)/d for 90 d, whereas control subjects received nothing. CBC tests were given at days 15, 45, and 90. Primary outcomes were 90-d changes from baseline in hemoglobin concentrations and hematocrit percentages. Linear mixed models and generalized estimating equations were used to model continuous and binary outcomes, respectively.Results: Of 179 anemic participants, 136 (76.0%) completed all follow-up assessments (65 intervention and 71 control participants). Baseline characteristics were comparable by arm. Mean hemoglobin and hematocrit increases after 90 d were greater for intervention than for control participants [1.4 g/dL (95% CI: 1.3, 1.6 g/dL) and 2.7% (95% CI: 2.2%, 3.2%), respectively]. The anemia prevalence at 90 d was lower for intervention (29.2%) than for control participants (98.6%) (OR: 0.007; 95% CI: 0.001, 0.04).Conclusions: The daily consumption of an iron-supplement bar leads to increased hemoglobin concentrations and hematocrit percentages and to a lower anemia prevalence in the target population with no reported side effects. This intervention is an attractive option to combat anemia in India. This trial was registered at clinicaltrials.gov as NCT02032615.

Hypochromic microcytic anemia: a clincopathological cross-sectional study

Background Iron-deficiency anemia, the most common cause of microcytic anemia, is a worldwide nutritional problem; its prevalence in the developing countries is three times higher than in the developed countries. It is a common disease in Egypt with a very high prevalence rate. It affects all age groups and all socioeconomic levels of the society. Identification of infants who are at risk for iron deficiency anemia (IDA) is vital as it impairs psychomotor development and growth and reduces physical activity and resistance to infection. Aim The aim of this work was to assess the prevalence of IDA among infants aged 6 months and 2 years presenting with hypochromic microcytic anemia and to determine the risk factors of iron deficiency among this age group. Participant and methods A total of 40 infants (6 months and 2 years) presenting with hypochromic microcytic anemia attending Alexandria University Children’s Hospital were included in this study. All were subjected to complete blood count, iron profile [serum ferritin (SF), serum iron, and total iron-binding capacity], and finding occult blood in stool. Those having normal iron profile were further subjected to capillary hemoglobin (Hb) electrophoresis and PCR for α-chain gene mutations to exclude β-thalassemias and α-thalassemias. Results Overall, 77.5% (31/40) of the studied infants had IDA, which represents the main cause of microcytic anemia in this study, whereas 17.5% (7/40) had β-thalassemia trait, diagnosed by increased HbA2 more than 3.5% by capillary Hb electrophoresis, and 5% (2/40) had α-thalassemia trait of the homozygous α3.7 (−α3.7/−α3.7) deletional type, detected by PCR for α-gene mutations. Moreover, this study showed that infants with IDA had significantly higher frequencies of preterm deliveries (48.38%) compared with β-thalassemia trait (14.28%), and α-thalassemia trait (0%), P=0.023, KWχ2=4.849. A significant positive correlation was found between Hb, serum iron, and SF levels of infants with IDA and both maternal Hb during pregnancy (r=0.937, P 6 months) (n=26), whose SF levels ranged between 2.0 and 5.9 μg/l, with a mean±SD of 4.04±1.10, P=0.001. Conclusion High prevalence of IDA was detected among infants presenting with microcytic hypochromic anemia (77.5%). The main risk factors for developing IDA include inadequate iron intake, preterm delivery, delayed onset of weaning, occult blood loss in stools owing to either early introduction of cow’s milk or parasitic infestations, and finally, infants born to young or anemic mothers.

A double-blind, randomized, and active-controlled phase III study of Herbiron drink in the treatment of iron-deficiency anemia in premenopausal females in Taiwan

BackgroundAbout 468 million non-pregnant women are estimated to suffer from iron-deficiency anemia (IDA) worldwide. The highest prevalence of IDA occurs in the Taiwanese population.ObjectiveTo evaluate the effectiveness of Herbiron to increase iron absorption in women with IDA.DesignPhase III double-blind, randomized, active-controlled, and parallel comparative study enrolled 124 patients with IDA and consisted of a 2-week run-in period, randomization, 12 weeks of supplementation, and 4 weeks of follow-up. The treatment group received Herbiron drink 50 mL p.o., b.i.d., before meals (daily iron intake: 21 mg/day) plus placebo tablets. The control group received a ferrous sulfate tablet, t.i.d., plus placebo 50-mL drink before meals (daily iron intake: 195 mg/day).ResultsBoth treatments significantly improved hemoglobin and all secondary efficacy endpoints. Most IDA patients treated with Herbiron or ferrous sulfate finished the study in the normal range. Ferrous sulfate treatment induced a rapid rate of hemoglobin synthesis, which plateaued by week 8, whereas Herbiron treatment increased the rate of hemoglobin synthesis more slowly, likely due to its nine-fold lower iron content. Gastrointestinal adverse events (diarrhea, abdominal pain, dyspepsia, and nausea) but not infectious adverse events were significantly more common in the ferrous sulfate group (n=11, 18.3%) than those in the Herbiron group (n=1, 1.6%) (p=0.004).ConclusionTwelve weeks of Herbiron treatment delivering 21mg of iron or ferrous sulfate treatment delivering 195 mg of iron induced normal hemoglobin levels in 62 or 91% of non-pregnant women with IDA in Taiwan, respectively, suggesting dose-dependent and bioavailability effects.