Management of Childhood Iron Deficiency Anemia in a Developed Country—A Multi-Center Experience from Croatia

Abstract

Iron deficiency anemia (IDA) continues to be a global public health concern, mostly in the developing countries. However, precise epidemiological data on childhood IDA in Croatia are lacking. In order to establish its frequency, underlying etiologies, the rationale for tertiary care visits, diagnostic practices, and current treatment regimens of IDA, medical records of children referred to pediatric hematologists for iron deficiency in a five-year period at tertiary institutions (Zagreb, Rijeka, Split, Osijek) throughout Croatia were retrospectively analyzed. Eight hundred and sixty-four children, predominately of preschool age, were referred mainly by the primary care pediatricians, who, in general, performed basic diagnostics but failed to initiate oral iron therapy in half of the patients. Approximately one-third of patients were symptomatic, with inadequate nutrition prevailing as underlying etiology. Dextriferron was the preferred iron formulation among hematologists, with a median dose of 5 mg/kg, with acceptable compliance rates (63.5–93.2%). Hospital admission rates varied among the centers (9.4–35%), and so did transfusion policies (6.4–22.9%). The greatest difference was observed in the frequency of parenteral iron administration (0.3–21.5%). In conclusion, the burden of childhood IDA, even in a high-income country, remains substantial, necessitating consistent implementation of national guidelines and additional education of primary health care providers.

Differentinating between non-transfusion dependant β-thalassemia and iron deficinecy anemia in children using ROC and logistic regression analysis: two novel discrimination indices designed for pediatric patients

“…Since children are the most vulnerable age group, especially in developing countries, creating a pediatric index that includes school and preschool children is necessary. The importance of this topic is proven by the latest works (1,2).…”

“…The discrimination between β-thalassemia (β-thal) and iron deficiency anemia (IDA) is of great socioeconomic importance. A recent multicenter study reports a 32.4% prevalence of IDA among infants in northwestern and 12% in children one year and older in central Croatia ( 1 ). Accurate and early diagnosis reduces costly and unnecessary laboratory testing.…”