Screening For Iron Deficiency Anemia Research Articles

Evaluating the Mentzer Index for Screening of Iron Deficiency Anemia and Beta Thalassemia Among Infants Visiting Primary Health Centers in Dubai, United Arab Emirates: A Retrospective Study.

The study aims to apply the Mentzer index to the population of all eligible pediatric patients presenting to primary healthcare centers (PHCs) in Dubai for the first year of life screening. Additionally, the study will estimate the prevalence of iron deficiency anemia (IDA) and β-thalassemia in children presenting to the PHCs and evaluate the importance of PHCs in screening children for IDA and β-thalassemia by comparing the results of this study to previous results. The SALAMA system (electronic medical record system used in PHCs in Dubai) was used for collecting the data. Eligible patients' data, such as hemoglobin, mean corpuscular volume (MCV), and red blood cell(RBC) counts were collected and recorded. The Mentzer index was applied to patients and the index results were compared to the gold standard results extracted from the SALAMA system. The gold standard diagnosis for IDA used was the serum ferritin test and the gold standard diagnosis for β-thalassemia used in the study was hemoglobin electrophoresis. Out of the 75 eligible patients with low hemoglobin, 11 (14.6%) had low ferritin indicating IDA. Moreover, eight (10.6%) patients had abnormal hemoglobin electrophoresis indicating β-thalassemia. The Mentzer index was applied to the patients; 13 (17.3%) of them had a value less than 13 (β-thalassemia) and 6 (8%) had a value more than 13 (IDA). The sensitivity of the Menzter index in screening IDA and β-thalassemia is 99% and the specificity is 54.5%. Our study found that the Mentzer's index is a reliable screening tool due to its high sensitivity; however, we suggest replicating the study with a larger sample size to get more clinically significant results.

High prevalence of iron deficiency and socioeconomic disparities in laboratory screening of non-pregnant females of reproductive age: A retrospective cohort study.

Iron deficiency anemia (IDA) and non-anemic iron deficiency (NAID) are highly prevalent among non-pregnant females of reproductive age. Canada has no national screening guidelines for this population. Screening, when performed, is often with a complete blood count alone without ferritin or iron indices. The primary objective was to determine the prevalence of screening for NAID and IDA over a 3-year period in non-pregnant females of reproductive age who had tests performed at outpatient laboratories in Ontario, Canada. Retrospective cohort study of non-pregnant females ages 15-54 in Ontario, from 2017 to 2019. NAID was defined as ferritin <30 μg/L, anemia as hemoglobin <120 g/L, and IDA as ferritin <30 μg/L and hemoglobin <120 g/L. Annual household income was estimated using patient postal codes. A total of 784 132 non-pregnant females were included. The 82.1% were screened for iron deficiency, 38.3% had NAID and 13.1% had IDA; 55.6% with IDA had normal mean corpuscular volumes. The median household income was $89454.80 compared with a provincial median of $65285.00. Patients in the lowest income quintile had the highest odds of being anemic, and the lowest odds of having a ferritin checked. A large proportion of non-pregnant females of reproductive age in this cohort were screened for iron deficiency. In this relatively privileged cohort, NAID affected nearly 40%, and IDA 13%. Most patients with IDA did not have microcytosis. Low household income was associated with the greatest odds of anemia and the lowest odds of being screened, highlighting inequitable access to screening for IDA in Ontario, Canada.

Food Consumption, Purchasing and Dietary Pattern of Farm Women in Dharwad District, Karnataka State, India

Present study was undertaken to analyze the socio-economic and nutritional status of women involved in farm activities and to know the impact of nutri-farms on food, nutrition and health security. Using 300 farm women in Chamarajanagar district. Health and nutritional status assessment, food intake, nutritional adequacy and screening for iron deficiency anaemia and KAP study on health and nutrition was conducted. Malnutrition is still one of the crucial problems in developing countries which is relationship between nutrition and health among a majority of the population. The objective of the study was dietary pattern of before and after intervention. This paper tries to analyze the food consumption and dietary pattern of women involved in farm activities and to know the impact of nutri-farms on food and nutrition security by using of 500 farm women in Dharwad district. A well-structured questionnaire was framed to gather the information on dietary pattern of the subjects was assessed by 24– hour diet recall method before and after intervention. The results revealed that, Among cereals, rice was consumed daily (90.4%) by all the families, where as food intake was observed that Pulses (67.67), milk and milk products (167.60), roots and tubers (67.80), GLV’s (47.17), other vegetables (96.47), fruits (37.33), fats and oil (17.70) consumption is very low when compared to RDA whereas consumption of cereal was on par with the recommended dietary allowances. The mean nutrient intake of energy (1794.5 kcal), protein (36.95 g), fat (17.95 g), iron (18.98 mg) and Vitamin C(42.85 mg) were less when compared to the RDA. The results shows that all nutrients and food intake consumption was found inadequate.

Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience.

Screening for iron deficiency anemia (IDA) is important in managing pediatric patients with inflammatory bowel disease (IBD). Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous (IV) iron to treat IDA in this population. To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center. A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019. 92 patients met study criteria for IDA, of which 57 received IV iron, 17 received oral iron, and 18 were discharged prior to receiving iron therapy. Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9 (± 0.2) g/dL in mean (± SE) hemoglobin (Hb) concentration by the first ambulatory follow-up, compared to patients who received oral iron 0.8 (± 0.3) g/dL or no iron 0.8 (± 0.3) g/dL (P = 0.03). One out of 57 (1.8%) patients that received IV iron therapy experienced an adverse reaction. Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.

Skrining Anemia Melalui Pemeriksaan HB, TIBC dan Serum Iron Pada Remaja Putri di SMK Baitul Hikmah Tempurejo

&lt;p&gt;&lt;em&gt;Anemia is a public health problem in Indonesia that can be experienced by all age groups, from toddlers to the elderly. One of them is young women, where these young women are prone to anemia due to a lot of blood loss during menstruation, young women who are entering puberty experience rapid growth so that the need for iron also increases and there is an incorrect diet pattern in rhymes. Adolescent girls who suffer from anemia are also at risk of developing anemia during pregnancy. This will have a negative impact on the growth and development of the fetus in the womb and has the potential to cause complications during pregnancy and childbirth. The purpose of this activity is to screen for iron deficiency anemia in young women as a preventive measure for anemia in adolescents which can cause long-term adverse effects on adolescents.&lt;/em&gt;&lt;/p&gt;&lt;em&gt;Screening for iron deficiency anemia in this activity was carried out through laboratory examination of panel iron levels, especially TIBC and Serum Iron examinations in young girls. The target for this activity is young women at Baitul Hikmah Tempurejo Vocational School. Screening begins with anamnesis and physical examination. If there are indications that lead to anemia, an iron panel examination (TIBC and serum iron) will be performed. The results obtained will be analyzed and consulted with the local regional health officer to get the right treatment&lt;/em&gt;

Abstract 12515: Effect of Intravenous Iron Therapy in Patients With Heart Failure and Iron Deficiency: A Meta-Analysis of Randomized Controlled Trials

Background: Iron deficiency is a frequently observed comorbidity in patients with chronic heart failure (HF). Present guidelines strongly advocate for the routine screening of iron deficiency anemia in all HF patients. Numerous randomized controlled trials (RCTs) have examined the efficacy and safety of intravenous iron-carbohydrate complexes as a supplementation approach for patients with HF with reduced ejection fraction (HFrEF). Nevertheless, there exists a necessity to systematically synthesize the evidence derived from these RCTs through a comprehensive meta-analysis. Methods: A comprehensive search was conducted in major electronic databases to identify relevant RCTs. Studies published from inception to April 2023 were scrutinized. Results: A total of 14 RCTs with 3597 patients were included in the analysis. The pooled analysis demonstrated a significant reduction in the composite outcome of cardiovascular death or hospitalization for worsening HF (OR 0.55, 95% CI= 0.45, 0.67; p &lt; 0.001). Similarly, the composite outcome of all-cause death or cardiovascular hospitalization showed a significant benefit with intravenous iron supplementation (OR 0.42, 95% CI= 0.28, 0.62; p &lt; 0.001). Moreover, the analysis indicated a significant decrease in hospitalizations for HF among patients receiving IV iron (OR 0.49, 95% CI= 0.32, 0.75; p &lt; 0.001). However, no statistically significant difference was observed in all-cause mortality (OR 0.90, 95% CI= 0.74, 1.10; p = 0.31) and cardiovascular mortality (OR 0.85, 95% CI= 0.68, 1.05; p = 0.14) between the two groups. Conclusion: The evidence from this meta-analysis underscores the significance of incorporating IV iron therapy in iron-deficient patients with systolic HF as it demonstrates significant improvements in patient outcomes.

Screening of iron deficiency anemia in children with chronic functional constipation

Background Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies worldwide. Constipation is one of the most common gastrointestinal disorders in childhood. Aim To screen for IDA or iron deficiency (ID) among children with chronic functional constipation (CFC). Patients and methods It was a prospective study. Two groups of children in the age range of 1–15 years were collected for 6 months from June 2022 to December 2022 at Alexandria University gastroenterology clinic. Children who fulfilled Rome IV criteria of CFC were assigned to CFC group. Children who did not have constipation were considered as the control group. Complete blood count, serum iron, total iron binding capacity, and serum ferritin were done for both groups. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. Quantitative data were described using range (minimum and maximum), mean, standard deviation, and median. Results Hemoglobin levels, serum ferritin and serum iron were significantly lower in the CFC group when matched with the control group. ID and IDA were significantly higher in the CFC group. The longer days of constipation were correlated with significantly lower hemoglobin, serum iron, and serum ferritin. Conclusion CFC causes mild IDA or ID. The longer the days of CF, the lower values of hemoglobin, iron and ferritin are present. ID and IDA are more common in the CFC group.

PRISM study-Pre-natal iron deficiency screening and management within an Australian regional centre.

Current Australian guidelines differ in their recommendations on optimal iron deficiency anaemia screening and management during pregnancy. A more active approach to screening and treatment of iron deficiency in pregnancy has been beneficial within a tertiary population. However, this approach has not been evaluated within a regional healthcare setting. To evaluate the clinical impact of standardised screening and management for iron deficiency in pregnancy within a regional Australian centre. Single centre, retrospective cohort observational study that audited medical records pre and post implementation of standardised screening and management for antenatal iron deficiency. We compared rates of anaemia at birth, rates of peripartum blood transfusions and rates of peripartum iron infusions. There were 2773 participants with 1372 participants in the pre-implementation group and 1401 in the post-implementation group. Participant demographics were similar. Anaemia at admission for birth decreased from 35% to 30% (RR 0.87, 95% CI (0.75, 1.00), p 0.043) Fewer blood transfusions were required (16 (1.2%) pre-implementation, 6 (0.4%) post-implementation, RR 0.40, 95% CI(0.16, 0.99), p 0.048). Antenatal iron infusions increased from 12% to 18% of participants post implementation (RR 1.47, 95% CI(1.22, 1.76), p 〈0.001).We audited compliance with the guidelines and found improvements post implementation. This is the first study to show clinically useful and statistically significant reduction in rates of anaemia and blood transfusions, post implementation of routine ferritin screening and management within a regional Australian population. The results of this study suggest there is benefit to implementation of standardised ferritin screening and management packages in Australian antenatal care. It also encourages RANZCOG to review current recommendations on screening for iron deficiency anaemia during pregnancy.

Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off.

Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.

Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study.

The objective of the study was to determine the diagnostic accuracy of Mentzer Index in children with hypochromic microcytic anemia by taking serum ferritin levels as a gold standard. This cross-sectional study was conducted in the Department of Pediatric Medicine, Liaquat National Hospital Karachi, from 1st January to 30th June 2022. Children age 1 to 5 years and both genders were included in this study. Children who have had a history of blood transfusion in the past 3 months or Thalassemia or blood disorders, chronic liver disease or kidney diseases, and children with malignancy and congenital abnormalities were excluded. Eligible children were enrolled after taking written informed consent. Complete blood count (CBC) and serum ferritin were sent to the laboratory. Sensitivity, specificity, diagnostic accuracy, and likelihood ratio were calculated taking serum ferritin levels as a gold standard. A total of 347 subjects were enrolled. The median age was 26 (IQR-18) months and 42.9% were males. The most common symptom was fatigue 40.9%. The sensitivity of the Mentzer index was 80.7% while the specificity was 77.7%. Similarly, the positive predictive value (PPV) was 56.8% while the negative predictive value (NPV) was 91.6%. Finally, the accuracy of the Mentzer index in determining iron deficiency anemia was 78.4%. Diagnostic accuracy was 78.4% and the likelihood ratio was 3.6. Mentzer index is a valuable tool in the early detection of IDA in children. It has got high sensitivity, specificity diagnostic accuracy, and likelihood ratio.

PUMPING IRON: A QUALITY IMPROVEMENT STUDY FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA IN AMBULATORY HEART FAILURE PATIENTS

PUMPING IRON: A QUALITY IMPROVEMENT STUDY FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA IN AMBULATORY HEART FAILURE PATIENTS

Reliability of transcutaneous hemoglobin measurements in an outpatient pediatric clinic

ABSTRACT Objective Our study assessed the reliability of a transcutaneous hemoglobin (tcHgb) measurement as compared to a standard capillary hemoglobin (cHgb) measurement in screening for iron deficiency anemia in a single university-based pediatric outpatient clinic. Methods Study participants included all pediatric patients requiring a hemoglobin (Hgb) assessment from July 2019 to June 2020. A tcHgb measurement was attempted on all children who received a cHgb measurement. Additional variables evaluated were age, visit type, gender, insurance type, weight, BMI percentile and presence of comorbid conditions. Results Of 777 attempts, both cHgb and tcHgb were obtained in 196 children aged 9 months to 21 years. Attempts were most successful in children > 2 years of age due to finger size and ability to remain still for one to two minutes. The mean cHgb was 12.5 ± 1.5 g/dL, mean tcHgb value 13.1 ± 2.1 g/dL, and the mean difference was 0.6 ± 2.1 g/dL (tcHgb-cHgb). An intraclass correlation coefficient was 0.29. There were no differences with regards to age, visit type, gender, insurance type, weight, BMI percentile and presence of comorbid conditions. Bland-Altman analysis displayed a lack of agreement between the tcHgb and cHgb measurements and tcHgb tended to over-estimate Hgb values when the cHgb was low. Conclusions The measurement of a transcutaneous Hgb is less invasive for pediatric patients but has significant limitations. Smaller children (probe specifications) and movement limited the ability to obtain a tcHgb measurement in ~75% of children tested. Falsely normal tcHgb values occurred due to overestimation of hemoglobin when compared to the traditional cHgb device. The suboptimal sensitivity of the tcHgb device may cause providers to miss a diagnosis of anemia. Future research should compare both methods of Hgb assessment to the gold standard laboratory-analyzed complete blood count and use a smaller probe for children under 2, once available.

Daily and Weekly Iron Supplementations to Improve Iron Status in Infants: A Randomized Controlled Trial

Background: Iron deficiency anemia screening and iron supplementation in infants aged 6 to12 months are recommended in the Guideline in Child Health Supervision. Objective: To evaluate the effectiveness of weekly iron supplementation compared with daily supplementation in improving the iron status in infants. Materials and Methods: A single-blind randomized controlled trial was conducted in infants aged 6 months visiting the Well Child Clinic between May 2019 and November 2020 at Burapha University Hospital, Chonburi, Thailand. The intervention consisted of either daily or weekly iron supplementation combined with iron-rich complementary food promotion for six months. The outcomes were the differences of serum ferritin and hematological variables before and after being iron supplemented. Results: Sixty-nine of the six-month-old healthy infants were randomized to receive either 10 mg Fe/day as the daily group or 30 mg Fe/week as the weekly group. Forty-five infants with 24 in the daily group and 21 in the weekly group completed the intervention. After the six-month period of iron supplementation, the average differences of serum ferritin in the daily and the weekly group were 10.85 (–13.19, 34.49) and –9.31 (–23.86, –2.30) ng/mL, respectively (p=0.012). The average differences of hemoglobin in the daily and the weekly group were 0.58±0.82 and 0.08±0.59 g/dL, respectively (95% CI 0.06 to 0.93; p=0.026). Conclusion: Daily iron supplementation of 10 mg/day is more effective than 30 mg weekly iron supplementation in improving iron status and hemoglobin level in the Thai infants. Keywords: Anemia; Ferritin; Infants; Iron deficiency; Iron supplementation

A Literature Review on the Relationship between Iron and Zinc Levels in Diabetes Mellitus and the Effects of Their Supplementation

This study aims to review the relationship between iron and zinc in diabetes mellitus and the effects of iron and zinc supplementation on changes in blood glucose levels. The results showed that diabetes mellitus was associated with low zinc levels and high levels of iron in body serum, as well as low iron levels in diabetes mellitus with iron deficiency anemia. Zinc supplementation in diabetes mellitus and iron in diabetes mellitus with iron deficiency anemia can reduce levels of fasting blood glucose and hemoglobin A1c. Nutritional therapy with zinc and iron supplements can decrease blood glucose levels with results that are influenced by dosage and period of supplementation. Screening for iron deficiency anemia needs to be done in diagnosing diabetes mellitus and implementing nutritional therapy with biomarkers of blood sugar levels in serum.

Iron Deficiency Anemia as a Risk Factor for First Febrile Seizures a Case Control Study

Background: Febrile seizures in children are a common problem. Iron deficiency anaemia is known, among other contributing factors, to be an aggravating factor in febrile seizures. Iron deficiency anaemia is a condition that can be avoided and managed. The study goal was to identify iron deficiency anaemia as a trigger factor for febrile seizures (FS). To determine the association between Iron Deficiency Anemia (IDA) and the first episode of febrile seizures (FFS). Subjects and Methods: Investigation like hemoglobin, blood indices (MCV, MCH), and serum iron and serum ferritin are done for detection of iron deficiency anaemia and their relationship with the first episode of febrile seizure was observed. Results: In our study comprising 50 cases and 50 controls, 58% (29) of cases were diagnosed as IDA with FS, 18% (9) of controls were diagnosed as IDA with Febrile Illness (FI). This suggests IDA as a risk factor for febrile seizures with a significant P value of &lt;0.001. Among 50 cases 42% (21) cases have FS without IDA and among 50 controls 82% (41) controls have FI without IDA were present in the current study. Conclusion: IDA was more common in children with FS than in those with febrile illness (FI) disease alone. The result suggests that the IDA can be a contributing factor to the FFS. Screening of IDA of children with FFS should be regarded. Fever can worsen the negative effects of anaemia or iron deficiency on the brain, which can lead to seizures.

Screening for Iron Deficiency Anemia in Infants in a Thalassemia-endemic Region.

Screening for iron deficiency anemia (IDA) in infants is usually carried out by hemoglobin (Hb) level and mean corpuscular volume (MCV). A coinherited thalassemia carrier may confound the diagnosis of IDA. This study aimed to characterize the hematologic parameters in infants with IDA and in thalassemia carriers, and to study the use of red cell parameters in IDA screening in a thalassemia-endemic area. Healthy infants, 6 to 12 months of age were enrolled. Blood samples were taken for complete blood count, ferritin level, Hb analysis, and polymerase chain reaction for alpha-thalassemia. IDA was defined as Hb <11.0 g/dL and ferritin <12 μg/L. Formulae calculated from red cell parameters to distinguish thalassemia carriers were analyzed. Eighty-five infants, 8.3±2.4 months of age, including 48 (56.5%) male infants were enrolled. Sixteen infants (18.8%) had IDA. There were 25 thalassemia carriers (29.4%), 1 Hb H disease, and 1 homozygous Hb E. Hb levels and MCV in the IDA and thalassemia carrier groups were significantly lower than those in the normal group. Area under the curve of Mentzer index (MCV/red blood cell count <13) to suggest thalassemia carriers was 0.867 (95% confidence interval: 0.784-0.951), and the sensitivity and specificity were 92.6% and 72.4%, respectively. In conclusion, both Hb level and Mentzer index are recommended for screening of IDA and thalassemia carriers in the population.

PREVALENCE OF IRON DEFICIENCY ANEMIA AMONG CHILDREN WITH SCHOOL FAILURE AND ITS RELATION TO INTELLIGENCE QUOTIENT

Introduction: An estimated 25% of school-aged children a worldwide is anemic. Iron deficiency is thought to account for about half of the global cases of anemia and is associated with inadequate dietary Recent years have shown a growing interest and concern in many countries about the problem of school failure and the determination of its main contributing factors. This problem is known as the “one hundred factors problem” and a great deal of research has been done on identifying the factors that affect the low performance of students (school failure and dropout) at different educational levels (primary, secondary and higher). Aim of the study: This study will be designed to evaluate the prevalence of iron deficiency anemia among children with school failure, the relationship between the degree of iron deficiency anemia (IDA) and changes in the level of intelligence quotient (IQ). Patients and Methods: This study is a prospective study on 100 children aged from 5 to 12 years old during the period from August 2018 – October 2019 and are divided in to two groups group A with IDA and group B without IDA. The patients who will be included in our study as anemic group who have: CBC: Hgb less than 11.5gm% Low MCV, Serum Ferritin: Less than 12ng/ml, and Free Erythrocyte Protoporphyrin: Increase than 23.8mg/dl. Then after confirmation that our patients are iron deficiency anemia the following was done for anemic and non-anemic group. Intelligence quotient: IQ was assessed by Stanford _Binet Intelligence scales. Before and after treatment, after correction of clinical and lab manifestations. Statistical analysis: Data were analyzed using Statistical Program for Social Science (SPSS) version 15.0. Quantitative data were expressed as mean ± standard deviation (SD). Qualitative data were expressed as frequency and percentage. Results: Prevalence of IDA was significantly higher among children with school failure. 68% of the studied group had IDA while the other 32% had no IDA (Mean hematological values of Hb, MCV and serum ferritn; respectively were low and FEP was elevated in anemic children, our results confirmed Free erythrocyte protoporphyrin (FEP) to be the most significant factor for the diagnosis of iron deficiency anemia in children, Our result revealed that there was a significant difference in the level of IQ between anemic and non-anemic group and in our study there was improvement of IQ after treatment with iron). Conclusion: The study found a positive correlation between IDA and poor school performance, although iron deficiency anemia (IDA) is a high risk factor for school failure but not the only cause in primary school children, free erythrocyte protoporphyrin (FEP) is the most sensitive and specific predictor for diagnosis of iron deficiency anemia in comparison to the other predictors although it is expensive. Recommendations: Pediatricians and mass media should raise awareness about iron deficiency and its sequelae, also the importance of the presence of the pediatric clinics for those apparently normal children. Screening of iron deficiency anemia in pale children and in poor school performance children to decrease its prevalence and impact on children. Proper complementary early feeding with iron rich foods to decrease iron deficiency anemia between infants and children. Treatment of IDA should occur early as possible by dietary improvement or by oral iron supplementation by giving 6mg elemental iron/kg/day divided into 2-3 doses continued for 2-3 month after correction of anemia to replenish body stores. Adding iron to widespread food as bread may be beneficial for prophylaxis of IDA.

A New Indicator Derived From Reticulocyte Hemoglobin Content for Screening Iron Deficiency in an Area Prevalent for Thalassemia.

To establish a new indicator derived from reticulocyte hemoglobin (Ret-He) content and red blood cell (RBC) indices for screening for iron deficiency anemia (IDA) in an area in whch thalassemia is prevalent. Blood specimens from 304 women aged between 18 and 30 years residing in northeast Thailand were collected and measured for RBC and reticulocyte parameters. Iron deficiency was diagnosed when a participant had a serum ferritin level of less than 15 ng per mL. Thalassemia genotypes were defined by hemoglobin (Hb) and DNA analyses. Of the total participants, 25% had iron deficiency (ID) and 50% carried the thalassemia gene. Various mathematical formulas were established and analyzed using the receiver operating characteristic (ROC) curve. The formula derived from Ret-He: (Ret-He/RDW-SD) × 10, was the best predictor for identifying ID among participants (area under the curve [AUC] = 0.812). Further testing of this indicator among individuals with positive thalassemia-screening results revealed stronger performance with an AUC of 0.874. The findings indicate that the formula derived from Ret-He might be applicable for screening ID in areas in which thalassemia is prevalent.

Screening for Anemia in Children with Down Syndrome.

As part of the 2011 American Academy of Pediatrics (AAP) health supervision guidelines for children with Down syndrome (DS), annual screening for iron deficiency anemia is recommended between the ages of 1 and 18 years, but the evidence supporting this recommendation is limited. This study aimed to assess the prevalence of anemia in patients with DS between the ages of 1 and 18 years to provide additional evidence for the AAP 2011 guideline recommendations for annual hemoglobin and ferritin screening in patients with DS. A retrospective cohort study was completed by obtaining data from the electronic health record (EHR) for patients meeting the following inclusion criterion: a diagnosis of DS in patients aged 1 to 18 years seen at our institution with hemoglobin drawn between July 2012 and 2016. Data were analyzed by the Fisher exact test and χ test. A total of 200 patients were identified. 22.5% had anemia, defined as a hemoglobin concentration less than 2 SDs for normed age. The National Health and Nutrition Examination Survey (2007-2010) reported prevalence of anemia for children aged 1 to 5 years is 3.2% when compared with 18.7% in our sample. Of the 45 children with anemia, 5% had a microcytic, 67.5% a normocytic, and 27.5% a macrocytic anemia. Only 10 received a diagnosis of anemia in the EHR. The prevalence of anemia in this cohort of children with DS is significantly higher than that in the general population, supporting the AAP guidelines for an annual screening until the age of 18 years.

The Need for Early Screening for Iron Deficiency Anemia in 9- to 12-Month-Old Infants

The Need for Early Screening for Iron Deficiency Anemia in 9- to 12-Month-Old Infants