Deficiencias de hierro y de vitamina A y prevalencia de anemia en niños y niñas de 6 a 24 meses de edad en Chaco, Argentina / Iron and vitamin A deficiencies and prevalence of anemia in boys and girls between 6 to 24 months of age in Chaco, Argentina

To determine the prevalence of anemia, and iron (ID) and vitamin A deficiencies aiming at their prevention, 414 children between 6 and 24 months of age, were randomly selected from the whole province of Chaco. A sociodemographic survey was implemented, and hemoglobin (Hb), plasma ferritin and retinol were measured. Anemia prevalence (Hb < 110 g/L) was 66.4 per cent, without differences between age groups, and included 18 per cent with Hb < 90 g/L. These cases were significantly less in children 6-8 month of age (5.1 per cent) than in the others (approximately equal to 20 per cent) (P: 0.007). Mean Hb was also higher in 6-8 months old children and was associated with lower prevalence of ID (ferritin < 12 micrograms/L) (p < 0.000) but not with age (p = 0.8865). ID already present, however, in 36.6 per cent of children in this age group, reached a prevalence of 72.9 per cent in children older than 18 months. Anemia prevalence was significantly higher in males, in children whose birth weight was < 3000 g, in those who had never taken iron supplements and among the poor, both structural and by income. Retinol values < 20 micrograms/dl occurred only in 5.1 per cent of children. Iron nutrition prior to, during pregnancy and in children during the first 2 years of life must be improved by joining strategies based on community empowerment aimed at improving dietary iron, assuring effective preventive supplementation and promoting the opportune umbilical cord ligation.

Deficiencia de hierro y anemia en mujeres embarazadas en Chaco, Argentina / Iron deficiency and anemia in pregnant women from Chaco, Argentina

Aiming at their prevention, to determine the prevalence of gestational iron deficiency and anemia, considering access to health care and associations with social and biological variables in the Province of el Chaco, Argentina. Three hundred and sixty four, randomly selected pregnant women from the whole province participated. Mean Hemoglobin (Hb) +/- SD dropped progressively from 118.4 +/- 11.0 to 112.1 +/- 11.5 g/L (p = 0.015) between the 1st and the 3rd gestational trimesters. Anemia prevalence (Hb < 110 g/L) was 17.4, 26.5 and 35.8 per cent. From the 1st to the 3rd trimesters. Second trimester prevalence was 14.1 per cent using Hb < 105 g/L as recently suggested. The ferritin geometric mean during the progressive gestational trimesters were 28.9; 16.0 and 11.1 micrograms/L. 21.7, 40.5 and 60.5 per cent had ferritins < 12 micrograms/L, and 39.1, 58.9 and 83.2 per cent had ferritins < 20 micrograms/L in these respective trimesters (p < 0.004 between trimesters in both cases). Both iron deficiency and anemia were significantly greater in women with unfinished primary education and with interpregnancy interval < 1 year. Seventy five percent of women had adequate number of antenatal visits but only 23 per cent were taking iron supplements and 10 per cent had stopped taking them. The prevention and correction of gestational iron deficiency and anemia must focus on the preconceptional period (inter-pregnancy spacing and increasing iron intake using all available means) as well as during pregnancy improving adherence to iron supplements by means of motivation of health workers and community.

Haemoglobin levels in West Indian antenatals

Studies conducted in the English-speaking Caribbean have shown that anaemia is a public health problem in pregnancy. However, these studies have been questioned because the World Health Organization (WHO) haemoglobin criteria, which are based on studies of North American and European women, may not apply to Caribbean women. Antenatal clinic records were studied at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. Over half of the antenatal women were between the ages of 21 and 27 years. Modal parity was 1 (41%) followed by a parity of 2 (31%). Median value for gestation was 13 weeks. The mean haemoglobin level was 12.4 ñ 1.5 gm/dl (median = 12.6). Twenty-one antenatal women (3.9%) had haemoglobin levels below 11 gm/dl and only 4 (0.6%) had haemoglobin levels below 10 gm/dl. The mean haemoglobin at the UHWI was 1.9 gm/dl higher than that of 159 patients from Antigua. However, the Antiguans were an average of 6 weeks further advanced in pregnancy. In Montserrat, the mean of 138 antenatal haemoglobin levels was 2.4 gm/dl lower than the UHWI mean/ these patients were also about 6 weeks further advanced in pregnancy. This study suggests that, given the right environment, the antenatal women in Montserrat and Antigua, who are of roughly the same ethnic origin as those from Jamaica, could achieve the same haemoglobin levels as those of pregnant women attending the antenatal clinic at the UHWI, Kingston, Jamaica