Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented

Abstract

Çullas-İlarslan NE, Günay F, İleri DT, Elhan AH, Ertem M, Arsan S. Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented. Turk J Pediatr 2018; 60: 22-31. Iron deficiency anemia (IDA) represents the most common cause of anemia worldwide. Because of potential irreversible neurodevelopmental impairment, its prevention during infancy is essential. We aimed to investigate the frequency of iron insufficiency among infants in a population which routine iron supplementation is implemented; and to examine related risks. A total of 501 infants, aged 9-15 months, were screened with complete blood count and serum ferritin. Infants were divided into two groups. [Group 1 (iron insufficient), [Group 1a: Iron deficiency (ID), Group 1b: IDA (IDA)], Group 2 (Iron sufficient (IS)]. Anemia was recognized in 122 (24.3%) infants. Microcytosis was observed in 110 (90.2%) of anemic infants. Group 2 accounted for 49.5% (n=248) whereas 152 (30.3%) and 101 (20.2%) infants belonged to Groups 1a and 1b, respectively. Multiple logistic regression analysis showed that male gender (OR=1.53; 95%CI 1.07 and 2.17), receiving > 500 ml/day cow`s milk (OR=2.77; 95%CI 0.87 and 8.83) and incompliance to iron supplementation (OR=2.51; 95%CI 1.75 and 3.60) were distinctive characteristics of Group 1 while prevalence of iron insufficiency was higher in infants consuming less formula (OR=3.10; 95%CI 2.00 and 4.80). The most frequent reasons for incompliance were consideration of supplementation as unnecessary (n=69, 31.1%) and neglection (n= 59, 26.6%). Our study demonstrated a high frequency of iron insufficiency among infants in a setting utilizing national iron supplementation and `incompliance` to iron as the most evident risk factor for iron insufficiency. Effective counseling of families by health care providers concerning importance of compliance to iron prophylaxis is essential for prevention of iron insufficiency. We also suggest screening of infants for ID as well as IDA in settings with high frequency of iron insufficiency.

Conocimientos sobre el tratamiento de anemia y su asociación con prácticas y actitudes de los padres

“…En relación con las actitudes encontradas en el estudio desarrollado en la India ( 11 ) y el Reino de Bahrein ( 9), más del 80% de las madres consideraba que la dieta resultaba suficiente para tratar la anemia, esto difiere con el 54,8% de padres encuestados los que manifestaban estar en desacuerdo frente a este enunciado; esta situación podría ser el resultado de la educación brindada durante la consejería nutricional, sesiones educativas y visitas domiciliarias. Referente a estar de acuerdo en suspender el tratamiento por causa de los efectos secundarios los porcentajes superan el 40%, a lo que conlleva a mejorar el proceso de educación, capacitación y vigilancia de las promotoras o agentes de salud y las madres, de tal manera que se brinde soluciones paliativas ante dichas situaciones ( 16,17 ).…”

“…La categorización y evaluación de las variables tuvo las siguientes consideraciones: cada variable contempló la aplicación de 10 ítems; sobre el nivel de conocimientos, cada respuesta correcta obtenía un puntaje de 2, además de utilizar para la calificación final una escala vigesimal con clasificación de bueno (16)(17)(18)(19)(20), regular (11)(12)(13)(14)(15) y malo (0-10). Las actitudes eran medidas a través de una escala de Likert de 5 niveles, que iba desde Muy en desacuerdo a Muy de acuerdo, puntuado de manera ascendente de 1 a 5.…”

Use of Vitamin, Mineral and Supporting Products in Children in Adana

“…According to a study conducted by Yalçın et al(14), the proportion of children who did not use prophylactic oral iron support was 31.2%. In a study conducted by Ilarslan et al(15), the rate for the same parameter was 44.3%. Reasons for stopping prophylaxis were; because the family found it unnecessary (31.1%), neglect (26.6%), side effects (16.6%), taste disturbance (15.3%).…”

“…Reasons for stopping prophylaxis were; because the family found it unnecessary (31.1%), neglect (26.6%), side effects (16.6%), taste disturbance (15.3%). Also, 6.3% were not informed by healthcare workers and 4.1% feared possible side effects indicated by their family members(15). Karapinar et al(16) found that iron prophylaxis was not initiated in 16% of children, 44.5% discontinued prophylaxis.…”

Prevalence of iron deficiency in infants aged 6–12 months and its relationship with socioeconomic level and iron prophylaxis use

“…[1] Recent studies indicate that the prevalence of anemia in children ranges from 7% to 24% in Türkiye. [2][3][4] Nutritional deficiency due to a diet low in iron is the primary cause of iron deficiency (ID). Other risk factors for ID include low birth weight, periods of rapid growth such as infancy, early introduction of cow's milk and solid foods, breastfeeding beyond six months without iron supplementation, the mother's low education level, and low socioeconomic status.…”