Prevalence of anaemia, iron deficiency, iron deficiency anaemia and risk factors for iron deficiency in Kelantanese children

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Date
2001
Authors
Ali Shibramulisi, Siti Noor
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Publisher
Universiti Sains Malaysia
Abstract
Iron deficiency (ID) is the most common nutritional deficiency in childhood (Dallman et al, 1980). Iron deficiency anaemia (IDA) in children less than 2 years causes behavioural abnormalities and developmental delay (Lozoff et al, 1991). Prevalence figures are therefore needed to estimate the scope of the problem and identification of potential risk factors associated with ID and IDA will help to formulate preventive strategies. To determine the prevalence of anaemia, ID and IDA in Kelantanese children aged 8 to 26 months. Secondary objective: To identify risk factors that best predict the presence of ID and to determine the validity of pallor in assessment of anaemia. A cross-sectional study was conducted from September 1999 to November 1999 in eight primary health clinics in the district of Kota Bharu. Children aged 8 to 26 months who attended these clinics were invited to participate in the study by convenience sampling. Children with chronic diseases, thalassaemia or an acute infection at the time of visit were excluded. Parents were interviewed using a standard pro forma containing questions on demographic data, dietary history and socio-economic influences. Pallor of conjunctiva was noted. Blood samples which were taken after obtaining a verbal consent were analysed for full blood count and ferritin level. The possible risk factors for ID were compared between the iron deficient (SF<121Jg/L) and iron sufficient (SF>121Jg/L) groups using bivariate analysis and multiple logistic regression. Among 490 children studied, 65.1% (95°/o Cl: 60.7-69.2o/o) were anaemic (Hb <11.0g/dl). The prevalence of ID (SF<12.0J.Jg/L) was 38.9o/o (95°/o Cl: 34.7- 43.5%) and prevalence of IDA (Hb<11.0g/dl & SF <12.01Jg/L) was 31.6°/o (95o/o Cl: 27.6-36.0%). Independent risk factors for ID were prolonged breast feeding, (OR 2.5; 95% Cl: 1.4-4.4%), failure to give formula milk (OR 1.7; 95% Cl: 1.1- 2.5%) and delayed weaning (OR 0.37; 95% Cl: 0.15-0.90%). Other dietary factors were not significantly associated with 10. None of the perinatal factors, socio-economic factors or the growth parameters were independently associated with 10. The sensitivity and specificity of pallor for detecting a Hb < 11.0g/dl were 70.5o/o 54.4o/o respectively. ID and IDA is a common problem among Kelantanese children. Prolonged breast feeding and failure to give formula milk were significantly associated with I D. Pallor of conjunctiva was not a sensitive or specific indicator for anaemia. Improvements and appropriate interventions of these potentially modifiable risk factors may reduce the incidence of anaemia and ID in Kelantanese children.
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Keywords
Iron deficiency (ID), Iron deficiency anaemia (IDA)
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