Risk factors for iron deficiency anaemia in preschool children in northern Ethiopia

Abstract

ObjectiveTo determine risk factors for anaemia in preschool children.DesignA cross-sectional study.SettingTigray province, northern Ethiopia.Subjects2080 of 2373 children aged 6–60 months provided blood to assess anaemia.ResultsAnaemia was highly prevalent (42%) and constituted an important nutritional problem in the region. In a sub-sample of 230 anaemic children, 56% had a low red blood cell (RBC) count, and 43% had a serum ferritin of less than 12 μg l−1 indicating that the anaemia was largely due to iron deficiency. Unlike other regions in developing countries, hookworm (0.4%) and malaria (0.0%) were rare and contributed little to the anaemia. Even though their diet lacked variety, the amount of iron consumed through cereal-based staple foods was adequate. However, the iron in these foods was not readily available and their diets were probably high in iron absorption inhibitors and low in enhancers. Dietary factors associated with anaemia included frequent consumption of inhibitors, such as fenugreek and coffee, and poor health in the child such as diarrhoea and stunting.ConclusionsUnderlying causes of anaemia were lack of safe water and inadequate human waste management, maternal illiteracy and mother being ill, and having no food reserves. The root cause of these factors was poverty. The optimal control strategy for iron deficiency anaemia should have a holistic approach which includes the alleviation of poverty, the empowerment of women and the provision of a safe environment.

Addressing Female Iron-Deficiency Anaemia in India: Is Vegetarianism the Major Obstacle?

“…This result is robust across different models. Our finding of a negative relationship between iron-deficiency anaemia and household wealth is consistent with findings that, in many developing countries and among poor cohorts in rich nations, poverty is a root cause of iron-deficiency anaemia [38][39][40]. In India, our data shows that an equally important root cause is vegetarianism, as 27% of women have a fairly strict vegetarian diet, defined as a diet without red meat, chicken, fish, and eggs.…”

Prevalência da carência de ferro e sua associação com a deficiência de vitamina A em pré-escolares

“…3,13 Although this is not within the scope of our study, we considered that, despite the fact that ID does not occur exclusively in underprivileged social classes, 16 low socioeconomic conditions of the studied group (per capita income of US$ 120/month) 3 helped to explain such a deficiency. 5,16,28,29 Low educational levels and, consequently, low wages and poor living conditions expose children to an unfavorable environment, preventing them from having access to information and from having a balanced diet, in addition to increasing the risks for infections that may aggravate ID. Iron deficiency can be managed with efficient measures in the short, medium and long term.…”

“…Measures that may have a medium to long-term effect include training and reskilling programs for health professionals, allowing for the early identification of these problems, reduction of fever or diarrhea through good vaccination coverage and the use of anthelmintics, w h e n e v e r n e c e s s a r y , b r e a s t f e e d i n g p r o m o t i o n , improvement of child care follow up and, finally, improvement of the quality of life of the population. 28,30 Such measures may also have an effect on the deficiency of other micronutrients, including VAD. 3 …”

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

“…Embora este não seja o escopo de nosso trabalho, consideramos que, apesar de a prevalência da CF não ocorrer exclusivamente em classes sociais desprivilegiadas 16 , as baixas condições socioeconômicas do grupo estudado (renda per capita de US$ 120/mês) 3 ajudam a explicar por que sobre ele predomina essa carência 5,16,28,29 . Baixos níveis de escolaridade e conseqüentes baixos salários e precárias condições de moradia expõem a criança a um ambiente desfavorável, impedindo-lhe o acesso à informação e a uma dieta balanceada, além de aumentarem a chance para a aquisição de infecções e/ou infestações que poderão levar ao agravamento da CF.…”

“…A curto prazo, a suplementação periódica e sistemática com sais de ferro, seja na forma medicamentosa, seja na forma de alimentos enriquecidos como já vem sendo realizado com sucesso em alguns locais constitui medida eficaz no combate desse problema. Promover treinamento e reciclagem dos profissionais de saúde visando à identificação precoce desses problemas, diminuição das doenças febris ou diarréicas através de uma boa cobertura vacinal e uso de vermífu-gos, quando necessário, estímulo ao aleitamento materno, melhoria do seguimento de puericultura e, finalmente, melhoria das condições de vida da população seriam medidas que surtiriam efeitos a médio e longo prazos no combate a esse problema 28,30 . Tais medidas, efetivamente, também teriam efeitos sobre a deficiência de outros micronutrientes, incluindo a DVA 3 .…”