Iron Deficiency Is Unacceptably High in Refugee Children from Burma

Abstract

Iron-deficiency anemia (IDA) in refugees is reported to be among the major medical problems worldwide. Because food rations are typically inadequate in iron, long-term reliance is a key predictor of anemia among displaced people. Comprehensive nutritional assessments of refugee children from Burma have not previously been completed. Refugee children aged 6-59 mo were studied to determine 1) the prevalences of anemia, iron deficiency (ID) and IDA and 2) the factors associated with anemia and ID. Cluster sampling in three camps and convenience sampling in two additional camps were used. Hemoglobin (Hb) levels were measured and micro mol zinc protoporphyrin/mol heme were determined in 975 children. Logistic regression analyses (95% CI) determined predictors of anemia and ID. The prevalences of IDA, anemia and ID in these refugee children were 64.9, 72.0 and 85.4%, respectively. Predictors of anemia included young age (P < 0.001), food ration lasting <1 mo (P = 0.001), daily consumption of dietary iron inhibitors (P < 0.05), weight-for-height Z-score of <-2 (P < 0.05), male gender (P < 0.05) and uneducated father (P < 0.001). Predictors of ID were young age (P < 0.001) and recently reported illness (P < 0.05). Laboratory tests confirmed that anemia and ID are major health problems among these refugee children and that ID is the leading cause of anemia. A comprehensive nutrition and public health-focused approach to combating anemia and ID is essential. Following the presentation of results to policy makers, the improvement of the micronutrient content of rations has been initiated.

Prevalence of Anemia and Its Risk Factors Among Children 6–36 Months Old in Burma

“…The overall prevalence in this population was 72.6%, which is consistent with the reported rate (72%) of refugee children 5-59 months on the Thailand/Burma border 8 ; however, this number is much higher than the mean prevalence (49%) in children of Southeast Asia. 16 It is worth noting that the anemia prevalence was unacceptably high (exceeded 90%) in KSR1 and Table 1 The association of sociodemographic characters and self-reported health status with anemia for children (6- SSR4; similar numbers were found in some parts of Asia in the 1980s.…”

“…This rate is much higher than the rate of 10.4% in the study with the refugee children. 8 Growth and development indicators of children. To maximally include children who are at risk, three different standards of defining wasting were used in this study; a child meeting any one standard was considered as wasted.…”

“…In the study, children 24 months were more likely to be anemic compared with older children, which is consistent with the literature information that anemia is common among children around the time of the growth spurt, especially between the ages of 6 and 24 months. 8,19 During that period, children's physical development is rapid, and the blood volume is largely expanded, whereas the iron storage from the maternal source has usually been depleted; diet becomes a vital source for iron as a result. 3 If exogenous iron is deficient, anemia occurs easily.…”

“…Only one study from 8 years ago reported that, with a food supply but inadequate intake of micronutrients, the anemia prevalence of children in refugees of the Burma/Thailand border was 72.0%. 8 There was little study of children from villages in rural areas, where children may suffer from not only micronutrient deficiencies but also a shortage of food.…”

Prevalence of iron deficiency and its association with vitamin A deficiency in preschool children

“…O mesmo foi observado em relação à DVA: todos os casos identificados na população foram subclínicos, pois nenhuma criança apresentava sinais de xeroftalmia 3 . Porém, muitos trabalhos da literatura que estudaram populações com elevadas prevalências de CF encontraram, também, elevadas prevalências de anemia 4,11,20,21 . A provável explicação dessa observação neste estudo está no fato de as crianças estudadas pertencerem à faixa de idade pré-escolar, sendo, portanto, de uma faixa etária de menor risco para a anemia ferropriva quando comparada com os lactentes.…”