Prevalence Of Iron Deficiency Anemia Research Articles

Predictors of iron deficiency anaemia among children aged 6-59 months in Tanzania: Evidence from the 2015-16 TDHS-MIS cross-sectional household survey.

Iron deficiency anaemia remains a public health problem, particularly in children aged 6-59 months. This study assessed factors associated with iron deficiency anaemia among children aged 6-23 months, 24-59 months and 6-59 months in Tanzania. Data for this cross-sectional study were extracted from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS). The study covered 8014 children aged 6-59 months and their mothers. Iron deficiency anaemia was defined (haemoglobin < 11g/dL). Univariable and multivariable logistic regression analyses that adjust for clustering and sampling weights were conducted to describe the associations between anaemia and potential confounding variables. The prevalence of iron deficiency anaemia among children aged 6-23 months, 24-59 months and 6-59 months were 76%, 49% and 59%, respectively. Factors associated with increased odds of iron deficiency anaemia among children aged 6-23 months included a mother being employed, being a male child, child perceived to small size at birth by mothers, a mother being anaemic and children belonging to the poorest socio-economic quintile. In addition, being a mother with no schooling, children not being dewormed, a mother being anaemic, delivering a baby at home, child fever and stunting, were factors associated with increased odds of iron deficiency anaemia among children aged 24-59 months. Factors associated with increased odds of iron deficiency anaemia among children aged 6-59 months were: a mother being employed, being a mother with no schooling, being a male child, belonging to the 6-59 months age bracket, a mother having a BMI of between 19 and 25 kg/m2, a mother being anaemic, having a baby at home, children belonging to bigger households, child fever and stunting. Interventions to minimise the burden of iron deficiency anaemia in children should target employed and/or anaemic mothers, poor and rich households, as well as male children.

Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants.

Iron deficiency prevalence in infants is high. Therefore, iron supplementation has been recommended and specified as a program. This study aimed to determine the characteristics of the prescription of ferrous sulfate as a preventive therapy for iron deficiency anemia in young infants. We conducted a descriptive cross-sectional study of clinical records of young infants with eight visits per year. We analyzed a total of 287 records. The prescription characteristics included five criteria prescription indication, age at prescription, dosage, periodicity, and time. These characteristics were scored as follows 1 point when it was considered adequate and 0 when it was considered inadequate; the minimum possible score was 0, and the maximum possible score was 5 points. Statistical analysis included percentages and 95% confidence intervals (CI). The prescription pattern of ferrous sulfate as preventive therapy in infants under one year of age was indicated in 100% of the records reviewed. All five criteria were met in 18.1% of the reviewed records (95%CI 13.6-22.6). The lowest compliance corresponded to adequate dosage (29.2%; 95%CI 23.9-34.5). Age at prescription was correct in 75.9% (95%CI 70.9-80.9); duration of prescription was correct in 44.2% (95%CI 38.4-50.0), and periodicity was proper in 31.1% (95%CI 25.9-36.7) of the files reviewed. Compliance with the prescription of ferrous sulfate as a preventive measure for anemia in infants was not as expected; interventions are needed to reverse this behavior.

Abstract 9537: Preliminary Analysis of the Impact of IV Iron Repletion in Patients With Iron Deficiency Anemia and Chronic Thromboembolic Pulmonary Hypertension Undergoing Pulmonary Thromboendarterectomy

Introduction: Iron deficiency anemia (IDA) is associated with worse functional class, shorter 6-minute walk distance (6MWD), and higher mortality in heart failure. The associations of IDA with chronic thromboembolic pulmonary hypertension (CTEPH) have not been established. Methods: Retrospective chart review of 95 patients with CTEPH who underwent pulmonary thromboendarterectomy (PTE) and had iron studies. We determined the prevalence of IDA and the impact of IV iron repletion in the perioperative period. Results: Of the 95 patients, the mean age was 56 years, 55% were female, 52% were White, and 28% were Black. Thirteen (13.6%) had IDA and received IV iron perioperatively when admitted for PTE. Those who had IDA were younger (50.3 vs 57.7 years, p=0.09) and female (69.2%). Of the females, 3 (33.3%) had uterine fibroids. Baseline hemoglobin was lower in the group requiring IV iron (10.5 vs 13.1 g/dL, p=0.0004). The patients received 1-5 days of IV iron. Cardiac index (CI) pre-PTE was not different between IDA versus non-IDA groups (2.4 vs 2.2 L/min, p=0.35) and the PVR was non-statically different (8.4 vs. 7.2 WU, p=0.63). Post-PTE, CI were normal in both groups (2.4 vs 2.7 L/min, p=0.03). The IDA group had worse baseline NYHA functional class (75% class III or higher, p=0.66) than the non IDA group (90% class II or lower, p=0.66). Those with IDA had lower baseline 6MWD of 277 vs 343 meters (p=0.14; Fig 1), despite a similar baseline PVR and CI. Post PTE and after IV iron repletion, 6MWD were similar between the IDA and non IDA group 385 vs 348 meters; p=0.75, respectively. Conclusion: Our results suggest younger and female CTEPH patients may have a higher incidence of IDA. IDA contributes to the functional capacity of patients with precapillary CTEPH. There is a trend towards improvement of the functional impairment in the CTEPH patients when they receive IV iron repletion in the perioperative period of PTE, in groups that have similar baseline CI and PVR, and normal CI in the post-PTE period.

Prevalence of Iron Deficiency Anemia and Reference Range of Complete Blood Count, Reticulocyte Parameters in Infants Aged 9-11 Months.

Iron deficiency anemia (IDA) is still a major global health problem. Determination of reference ranges for complete blood count (CBC), reticulocyte hemoglobin content (Ret-He), immature reticulocyte fraction (IRF), and reticulocyte production index (RPI) are essential to help diagnose a disease. The study aims to know the prevalence of IDA, risk factors that influence it, and set a reference range for CBC and reticulocyte parameters in infants aged 9-11 months in Indonesia. The study was conducted prospectively at 10 Community Health Centers in Banjarbaru, South Kalimantan, Indonesia, from August 2020 to August 2021. This study recruited 100 healthy infants (47% boys, 53% girls) aged 9-11 months. The prevalence of IDA was 32%. There is no association between IDA prevalence with the mother's education and occupation, maternal parity, family income, and infant nutritional status (p > 0.05). The reference range for hemoglobin (Hb) at P2.5-P97.5, P3-P97, P5-P95 and mean ± 2SD was 11.06 to 14.34 g/dL, 11.10 to 14.31 g/dL, 11.13 to 13.90 g/dL and 10.57 to 13.65 g/dL, respectively. This study also defined the reference ranges for reticulocyte parameters. The reference range of CBC, Ret-He, IRF, and RPI for healthy infants aged 9-11 months in this study can be used as a benchmark.

Frequency of Iron Deficiency Anemia (IDA) Among Patients with Helicobacter Pylori Infection

Objective: The purpose of this study is to identify the prevalence of iron deficiency anaemia (IDA) in helicobacter pylori-infected patients. Study Design: Prospective/cross-sectional study Place and Duration: This study was conducted at Benazir Bhutu Hospital Rawalpindi during the period from July, 2022 to September, 2022. Methods: Total 105 patients of Helicobacter pylori infection, who ranged in age from 18 to 65 years included. All patients gave their informed written consent after being asked about their age, sex, body mass index, level of education, and place of residence. Blood samples from the subjects were analysed to determine their levels of serum iron, transferrin saturation, ferritin, and total iron-binding capacity. H. pylori infection can be found by histopathology, stool antigen testing, a fast urease test, or a urea breath test. The entire data set was analyzed using SPSS 24.0. Results: Among all there were majority females. Majority of the patients were illiterate and were from rural areas. 60 (57.1%) had poor socio-economic status. Mean Hemoglobin level was 12.1±0.6 (g/dl) mean serum iron level was 49.8 ±10.33(ug/dl) and mean serum ferritin level was 121.7±42.87 (ng per ml).Frequency of iron deficiency anemia was found in 43 (40.95%) patients. Among 43 cases of IDA, majority of the patients had age &gt;35 years. Conclusion: In this research, we found that patients with helicobacter pylori infection, the majority of whom were adult female patients, had a considerably greater frequency of iron deficiency anaemia. Keywords: Prevalence, H.pylori infection, Iron Deficiency Anemia (IDA), Females

Haematological Indices and Serum Ferritin as Diagnostic Tools for Anaemia among Village Primary Pupils in Kaduna state, Nigeria

Background: Anaemia is one of the major public health issues worldwide. Children in the developing world are vulnerable to iron deficiency anaemia (IDA) and iron deficiency (ID) because they are rising at a fast pace and consume diets low in iron. This study aims at assessing the level of anaemia in children aged 6-12years in rural Nigeria, using hematological indices and serum ferritin as diagnostic tools. Methods: This is a cross-sectional study carried out in two primary schools in Kumin Masara Kataf village in Kaduna state on schoolchildren aged 6-12years. Data collected include personal information and laboratory data such as haemoglobin content, and serum ferritin to determine iron status. Data analysis was done using IBM-SPSS Inc., Chicago, IL, USA version-25.0. Results: The overall mean haemoglobin was 10.11±1.02g/dl with 10.37±0.97g/dl and 10.02±1.02g/dl for children aged 10-12 and 6-9 years respectively (p=0.033). The overall serum ferritin was 15.37±4.87mg/L with 17.20±5.23mg/L among subjects aged 10- 12 and 14.72±4.58mg/L for 6-9 years (p=0.002). The prevalence of anaemia was 13.6%, IDA (50.3%), ID (30.9%), and iron depletion (5.8%). There was a significant difference between the prevalence of iron status according to age group (6- 9vs.10-12), P&lt;0.05. Males had a higher prevalence of anaemia (69.2%) than females but females recorded a higher prevalence of IDA (51.6%) and ID (61.0%). Conclusion: This study found a high prevalence of IDA and ID among the rural schoolchildren in Nigeria. We recommend that healthcare providers should focus more on prevention of IDA at childhood rather than during pregnancy.

Prevalence of iron deficiency anemia in pregnancy and its therapeutic response to treatment: a retrospective audit in a tertiary hospital

Background: Iron deficiency anemia is the commonest type of nutritional anemia seen during pregnancy. Despite implementing oral iron prophylaxis in pregnancy, IDA in pregnant women constitute a major health problem. The present study aims to look at the prevalence of IDA in a pregnant population in Seremban, Malaysia and their response to treatment.Methods: This is a retrospective study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered between October 2019 to March 2020 in a state hospital in Seremban, Malaysia and their response to treatment. Main outcome measures were the prevalence of iron deficiency anaemia, associated demographic and clinical factors and response to iron therapy. Results: About 920 patients’ records were included for analysis. The prevalence of anaemia in this cohort was 42.8% (N=394). The prevalence of iron deficiency anemia (IDA) was 31.5% (N=124) among the anemic patients or 13.5% of the studied population. The mean hemoglobin level for this group was 10.0±0.74 g/dl (6.8-10.9 g/dl) and majority had mild anemia (91.9%, N=114). 68.5% IDA patients were successfully treated by 36 weeks pregnancy. Of the remaining 39 patients who were still anemic, 37 (94.9%) had mild anemia with mean hemoglobin level of 10.3g/dl (SD 0.48, range 9.0-10.9 g/dl). Conclusion: Current treatment strategy is inadequate to achieve the set national target. There is a role for an early recourse to parenteral iron therapy to improve treatment outcome.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study.

Iron deficiency anemia (IDA) in adolescent girls is a problem that has not been resolved. This study aimed to explore the critical aspects of an integrated health care system model for preventing IDA in adolescent girls in a rural area of Indonesia. This qualitative research employed a grounded theory approach in order to build a substantive theory. This study used in-depth interviews with adolescents, parents, teachers, health workers, and persons in charge of adolescent programs at the health office, education office, and ministry of religion. Purposive sampling was performed until data saturation was achieved. Codes, categories, and themes were generated through thematic data analysis to develop a substantive theory. Data analysis was performed using MAXQDA 2022 software. A total of 41 people participated in this study. This investigation generated twenty-two categories and seven themes. These themes relate to policymaker commitments, stakeholder governance, quality, adolescents' lifestyles, adolescents' self-factors, adolescents' access to health services, and social support. The themes identified become fundamental aspects of the integrated health care system model for preventing IDA in adolescent girls. The model of the integrated health care system consists of several essential points, which include awareness and efforts from policymakers and adolescent girls, supported by parents, teachers, and the community.

Assessment of anemia among rural children in Kaduna State, Nigeria by determining hemoglobin and serum ferritin levels

Background and objective: Children in the developing world are vulnerable to iron deficiency (ID) and iron deficiency anemia (IDA) because they grow fast and consume diets low in iron. Thus, this study assessed anemia in children aged 6 - 12 years in rural Nigeria, using hematological indices and serum ferritin as diagnostic tools. Materials and methods: This cross-sectional study was carried out in two primary schools in Kumin Masara Kataf village in Kaduna state, Nigeria. School children aged 6 - 12 years were enrolled. Personal information and laboratory data were collected. Hemoglobin and serum ferritin concentration was estimated to determine anemia and iron status. Data analysis was done using IBM-SPSS Inc., Chicago, IL, USA, version-25.0. Results: A total of 191 school-age children aged 6 - 12 years were enrolled in the study. The overall serum ferritin was 16.51±5.20 mg/L, but the children aged 6 - 9 years had significantly (p&lt;0.05) higher serum ferritin (17.23±5.57 mg/L), compared to children aged 10-12 years (15.62±4.62). The mean hemoglobin concentration and serum ferritin were significantly (p&lt;0.05) more elevated among males (11.17±2.53g/dl and 19.01±5.06 mg/L, respectively) than females (10.18±2.46 g/dl and 14.03±4.02 mg/L respectively).The overall rate of anemia was 51.3%, while IDA was 70.4% (69/98). Iron deficiency was present in 47.3% (44/93) children. Also, anemia was significantly (p&lt;0.001) more prevalent among females (66.7%), than males (35.8%), and a higher proportion of females (87.5%) than males (26.2%) were iron deficient (p&lt;0.05), but more males (44.1%) had IDA, p&lt;0.05. Conclusion: This study found a high prevalence of IDA and ID among rural school children in Nigeria. It is recommended that healthcare providers focus more on preventing IDA right before childhood. IMC J Med Sci. 2023. 17(1): 006. DOI: https://doi.org/10.55010/imcjms.17.006 *Correspondence: Andrew Nuhu Yashim, Haematology and Blood Transfusion Department, National Hospital, Abuja, Nigeria. Email: yashimnuhuandrew@gmail.com

Antioxidant and Biological Activities of the Lotus Root Polysaccharide-Iron (III) Complex.

In this study, the synthesis parameters of the lotus root polysaccharide iron complex (LRPF) were determined and optimized by response surface methodology. Under the optimum preparation conditions, the pH of the solution was 9, the ratio of M (trisodium citrate): m (lotus root polysaccharide) was 0.45, the reaction time was 3 h. UV spectroscopy, thermogravimetry, FT-IR spectroscopy, X-ray diffraction, CD, and NMR were used for the characterization of the LRPF. LRPF has good stability and easily releases iron ions under artificial gastrointestinal conditions. LRPF exhibited antioxidant activity in vitro and can significantly improve the antioxidant activity in vivo. In addition, LRPF has a good effect in the treatment of iron deficiency anemia in model mice, impacts the gut microbiome, and reduces the iron deficiency-induced perniciousness by regulating steroid hormone biosynthesis. Therefore, LRPF can be used as a nutritional supplement to treat and prevent iron-deficiency anemia and improve human immunity.

Benefits and Risks of Early Life Iron Supplementation.

Infants are frequently supplemented with iron to prevent iron deficiency, but iron supplements may have adverse effects on infant health. Although iron supplements can be highly effective at improving iron status and preventing iron deficiency anemia, iron may adversely affect growth and development, and may increase risk for certain infections. Several reviews exist in this area; however, none has fully summarized all reported outcomes of iron supplementation during infancy. In this review, we summarize the risks and benefits of iron supplementation as they have been reported in controlled studies and in relevant animal models. Additionally, we discuss the mechanisms that may underly beneficial and adverse effects.

Ferritin and its association with anaemia in a healthy adult population in Kenya.

BackgroundIron deficiency is the commonest cause of anaemia worldwide. Serum ferritin is the most sensitive non-invasive indicator of iron stores but its utility is compromised in inflammatory states as it is an acute phase reactant. This study sought to estimate the burden of iron deficiency in a healthy adult population residing in Kenya and to determine the association between various ferritin cut-offs and anaemia in a population known to have chronic low-grade inflammation.MethodsHealthy adults aged 18–65 years were recruited from urban towns in 4 counties in Kenya at average altitudes of 1683-2099m above sea level as part of a global study conducted by the International Federation of Clinical Chemistry (IFCC) to determine reference intervals (RIs) for common laboratory tests. We analyzed complete blood count (CBC), C-reactive protein, iron, transferrin, transferrin saturation and ferritin data.ResultsWe obtained data from 528 participants. There were 254 (48.1%) males and 274 females (51.9%). Based on a ferritin cut-off of 15 μg/L and Hb cut-offs of 14.5 g/dL and 12 g/dL, the prevalence of iron deficiency anaemia was 0.8% and 7.3% in males and females respectively. The odds of having anaemia was highest if one had a ferritin value less than 15 μg/L with a sensitivity of 28.6% and specificity of 98.4% in males, and sensitivity of 83.3% and specificity of 78.0% in females.ConclusionOnly the ferritin cut-off of 15 ug/L had an association with anaemia where it can be used for ruling out iron deficiency as the cause. Sex specific ferritin cut-offs for diagnosing iron deficiency in adults in sub-Saharan Africa need to be derived by comparing ferritin levels to stainable iron in bone marrow aspirates and trephines in order to ensure that we are using appropriate clinical decision limits.

Estimating the changing disease burden attributable to iron deficiency in South Africa, 2000, 2006 and 2012.

Worldwide, iron deficiency, and consequent iron-deficiency anaemia, remains the most common nutritional disorder. Iron-deficiency anaemia mostly affects young children and women of reproductive age, especially in Asia and Africa. Iron deficiency may contribute to disability directly or indirectly as a risk factor for other causes of death, and may rarely contribute to death. To estimate the changing burden of disease attributable to iron deficiency in males and females (all ages) for the years 2000, 2006 and 2012 in South Africa (SA). The comparative risk assessment methodology developed by the World Health Organization (WHO) and the Global Burden of Diseases, Injuries, and Risk Factors Studies was used to estimate the burden attributable to iron deficiency in SA for the years 2000, 2006 and 2012. We attributed 100% of the estimated iron-deficiency anaemia burden across all age groups by sex to iron deficiency. For maternal conditions, the attributable burden to iron deficiency was calculated using the counterfactual method and applied to all women of reproductive age. The population attributable fraction calculated for these selected health outcomes was then applied to local burden estimates from the Second SA National Burden of Disease Study (SANBD2). Age-standardised rates were calculated using WHO world standard population weights and SA mid-year population estimates. There was a slight decrease in the prevalence of iron-deficiency anaemia in women of reproductive age from ~11.9% in 2000 to 10.0% in 2012, although the prevalence of anaemia fluctuated over time (25.5% - 33.2%), with a peak in 2006. There has been a gradual decline in the number of deaths from maternal conditions attributable to iron deficiency in SA between 2000 (351 deaths (95% uncertainty interval (UI) 248 - 436)) and 2012 (307 deaths (95% UI 118 - 470)), with a peak in 2006 (452 deaths (95% UI 301 - 589)). Furthermore, our analysis showed a 26% decrease between 2000 and 2012 in the age-standardised burden rates from maternal conditions (truncated to 15 - 49 years) attributable to iron deficiency. Between 2000 and 2012, the age-standardised disability-adjusted life year (DALY) rate from iron-deficiency anaemia attributable to iron deficiency markedly decreased by 33% in males, and increased by 3% in females of all ages. Approximately 1.1 - 1.4% of all DALYs in SA from 2000 to 2012 were attributable to iron deficiency. Iron-deficiency anaemia prevalence can be markedly reduced if iron deficiency is eliminated. Hence it is essential to encourage, reappraise and strengthen the measures that have been put in place to address iron deficiency, especially in women of reproductive age and children.

Polyphenol-Rich Ginger (Zingiber officinale) for Iron Deficiency Anaemia and Other Clinical Entities Associated with Altered Iron Metabolism.

Ginger (Zingiber officinale) is rich in natural polyphenols and may potentially complement oral iron therapy in treating and preventing iron deficiency anaemia (IDA). This narrative review explores the benefits of ginger for IDA and other clinical entities associated with altered iron metabolism. Through in vivo, in vitro, and limited human studies, ginger supplementation was shown to enhance iron absorption and thus increase oral iron therapy’s efficacy. It also reduces oxidative stress and inflammation and thus protects against excess free iron. Ginger’s bioactive polyphenols are prebiotics to the gut microbiota, promoting gut health and reducing the unwanted side effects of iron tablets. Moreover, ginger polyphenols can enhance the effectiveness of erythropoiesis. In the case of iron overload due to comorbidities from chronic inflammatory disorders, ginger can potentially reverse the adverse impacts and restore iron balance. Ginger can also be used to synthesise nanoparticles sustainably to develop newer and more effective oral iron products and functional ingredients for IDA treatment and prevention. Further research is still needed to explore the applications of ginger polyphenols in iron balance and anaemic conditions. Specifically, long-term, well-designed, controlled trials are required to validate the effectiveness of ginger as an adjuvant treatment for IDA.

Effectiveness of Dietary Intervention with Iron and Vitamin C Administered Separately in Improving Iron Status in Young Women.

In order to maintain an adequate iron status in young women, effective dietary interventions should provide sufficient amounts of iron in everyday meals and improve the bioavailability of non-heme iron by providing vitamin C. While some intervention studies administering products rich in vitamin C in conjunction with iron sources showed improved iron status, it is unknown whether a separate administration of products rich in iron and vitamin C may be a successful strategy as well. The aim of this study was to assess the effectiveness of dietary intervention with iron and vitamin C administered separately in improving iron status in young women to prevent iron deficiency anemia. The study was conducted in a group of 29 women aged 18–30, and an 8-week dietary intervention was performed. Study participants with an adequate iron status received 50 g of iron-fortified oat flakes (as a source of non-heme iron) with breakfast and 200 mL of orange juice (as a source of vitamin C) in the second part of the day. Iron status was analyzed based on red blood cells, hemoglobin, hematocrit, serum ferritin, and serum iron, and it was assessed at baseline, after 4 weeks, and after 8 weeks of the intervention. The intakes of iron, vitamin C, and folate were controlled throughout the study period, and menstrual blood loss was estimated. After 8 weeks of intervention, statistically significant differences compared with baseline were observed only for hematocrit, as its level after 8 weeks of intervention was higher than the baseline (p = 0.0491). Comparing subsamples within the dietary intervention considered effective and ineffective for red blood cell levels, it was indicated that lower baseline vitamin C intake may result in a more effective dietary intervention (p = 0.0231). Comparing subsamples within the dietary intervention considered effective and ineffective for hemoglobin, hematocrit, iron, and serum ferritin levels, it was indicated that higher baseline levels of hemoglobin (p = 0.0143), hematocrit (p = 0.0497), iron (p = 0.0101), and serum ferritin (p = 0.0343) respectively may result in a more effective dietary intervention. It was concluded that dietary intervention with iron and vitamin C administered separately may be effective in improving iron status in young women to prevent iron deficiency anemia. It may be concluded that in the studied group, a better baseline iron status and lower baseline vitamin C intake may result in a more effective dietary intervention with iron and vitamin C administered separately to improve iron status in young women.

Magnitude and morphological types of anemia differ by age among under five children: A facility-based study

BackgroundWorld Health Organization recently acknowledged the proportion of anemia attributable to iron deficiency among under-five children could be lower than the previously assumed 50%. Ethiopia reported 8.6% and 12.3% prevalence of iron deficiency anemia by serum ferritin and soluble transferrin receptor respectively. However, evidence generated from large samples on the magnitude of different types of anemias is limited. We aimed to determine the prevalence and morphological types of anemia in relation to age. MethodsA retrospective analysis was conducted using electronic records of hemoglobin and red blood cell indices of 4739 children of 6–59 months of age who visited Hawassa University Comprehensive and Specialized Hospital from May 2017 to May 2019. Microcytic hypochromic morphology combined with high red cell distribution width was used to estimate the prevalence of iron deficiency. ResultsAbout 44.7% of the children were anemic. Anemia affected 6–23 months old children (53.1%) more than 24–59 (37.2%) months (p < 0.001) with no difference among boys and girls. Iron deficiency and iron-deficiency anemia, as explained by microcytic hypochromic morphology with high red cell distribution width combined model, were estimated to be 38.6% and 24.1%, respectively. About 54% of anemic children had iron deficiency which was higher among 6–23 months (63.5%) than 24–59 months (41.8%) (P < 0.001; X2 = 98.883). Regardless of anemia status, iron deficiency was two-fold higher among 6–23 months old children than 24–59 months of age. On the contrary, normocytic normochromic anemia affected significantly 24–59 months old children (23.1%) compared to 6–23 months. Less than 6% of the total anemia was macrocytic showing no significant relation with age. About 96% of macrocytic anemia was coupled with high red cell distribution width, indicating folate and vitamin B12 deficiency. ConclusionsMicrocytic hypochromic anemia with high red cell distribution width was the most prevalent type affecting primarily under two children. Normocytic normochromic anemia was significant among 24–59 months while macrocytic anemia had no age-related pattern. An in-depth study of causes of anemia other than iron deficiency particularly among 24–59 months children is essential.

Childhood and Adolescent Anemia Burden in India: The Way Forward

The burden of anemia in Indian children, based on capillary blood sampling, is believed to be profound and worsening (67.1%) according to the successive National Family Health Surveys (NFHS). This might be an overestimate. The recent Comprehensive National Nutrition Survey of Indian children, that used venous blood sampling, found only less than half (30.7%) the NFHS prevalence, of which only one third was due to iron deficiency (ID). Unfortunately, the apparently worsening NFHS anemia burden estimate has been interpreted as an inadequacy of the present iron supplementation policy. This has led to additional iron supply through mandatory rice fortification. However, the lack of efficacy of iron supplementation appears inevitable, if the true prevalence of iron deficiency anemia is only about 10%. Thus, etiology is a critical consideration when devising appropriate and effective prevention policies. Future policies must focus on precision, thoughtfulness, restraint, and community engagement.

Polymorphisms of haptoglobin modify the relationship between dietary iron and the risk of gestational iron-deficiency anemia.

To assess whether polymorphisms of haptoglobin (Hp) modify the relationship between dietary iron and the risk of gestational iron-deficiency anemia (IDA). This study analyzed 1430 singleton pregnant women aged 20 ~ ≤ 48years from the 2017-2019 National Nutrition and Health Survey of Pregnant Women in Taiwan. Sociodemographic, blood biochemical, Hp phenotype, and 24-h dietary recall data were collected. Erythropoiesis-related total prenatal supplementation was defined as the reported use of multivitamins and minerals, vitamin B complex, folate, and iron. Distributions of the Hp 1-1, Hp 2-1, and Hp 2-2 phenotypes were 13.6, 39.8, and 46.5%, respectively. Women with the Hp 1-1 phenotype had the lowest mean levels of serum ferritin (p-trend = 0.017), the highest prevalence of gestational ID (p-trend = 0.033) as well as the highest prevalence of gestational IDA (did not reach statistical differences, p-trend = 0.086). A gene-diet interaction on serum ferritin was observed between the Hp 1 and Hp 2 (2-1/2-2) alleles (p < 0.001). An adjusted multivariate logistic regression showed that compared to those with a normal blood iron status and who reported using erythropoiesis-related total prenatal supplements, those who did not had a 4.05-fold [odds ratio (OR) = 4.05 (95% confidence interval (CI) 2.63-6.24), p < 0.001] increased risk of gestational IDA. The corresponding ORs for carriers of the Hp 1 and Hp 2 alleles were 4.78 (95% CI 1.43-15.99) and 3.79 (95% CI 2.37-6.06), respectively. Pregnant women who are Hp 1 carriers are at increased risk for developing IDA if they do not meet the recommended dietary allowance for iron or use erythropoiesis-related prenatal supplements.

Maternal nutritional awareness and iron deficiency anemia in children aged 6 months–2 years in a tertiary care hospital in Coimbatore, Tamil Nadu

Objective: This study aims to analyze the risk factors and vital role of mothers in prevention of nutritional anemia in the early childhood. Methods: A hospital-based cross-sectional study done in Coimbatore for 2 years. Using a pre-tested structured validated tool, mothers of children aged 6 months–2 years were interviewed to collect information on factors contributing to anemia with special regard to maternal knowledge. Results: Anemia was more in the latter half of infancy (67.2%) with male predominance (60.5%). An affirmative association between increased cow’s milk intake and low hemoglobin was present (p=0.002). Employed and less educated mothers had more anemic children (p&lt;0.05). Of 16% mothers classified as “poor” awareness, 95.45% children had low hemoglobin (p&lt;0.05). Conclusion: Recognizing the causative factors plays an essential role in preventing iron deficiency anemia (IDA). Exclusive breastfeeding must be promoted, along with avoiding excessive cow’s milk intake. Intervening at the right period with age-appropriate foods becomes a necessity. Maternal illiteracy has a positive correlation with anemia in infants. Improving maternal awareness by the physicians will pave the road toward a nation free from anemia.

Maternal iron deficiency anaemia in pregnancy: Lessons from a national audit.

We describe the management and the prevalence of iron deficiency anaemia (IDA) during pregnancy by comparison to standards. A cross-sectional national cohort study of women who had given birth six weeks prior to data collection was conducted at maternity units in the UK and Ireland. Participating centres collected data from 10 consecutive pregnant women. Analysis was descriptive to define the prevalence of IDA in pregnancy and the puerperium, and to compare the outcomes in women who had IDA with women who did not have anaemia anytime during pregnancy. Eighty-six maternity units contributed data on 860 pregnancies and births. The overall prevalence of IDA during pregnancy was 30.4% and in the puerperium 20%. Anaemic women were more likely to be from ethnic minorities, odds ratio 2.23 (1.50, 3.32). Adherence to national guidance was suboptimal, and the prevalence of anaemia in pregnancy remains very high. There is pressing need to explore barriers to early identification and effective management of iron deficiency. IDA should be considered a major public health problem in the UK.