Atención Integrada a las Enfermedades Prevalentes de la Infancia-AIEPI, para ferropenia en niños / Integrated management of childhood illness (IMCI) for iron deficiency in children

Objetivo Evaluar la aplicación de la estrategia AIEPI en la prevención, detección y el tratamiento de la ferropenia en menores de 5 años atendidos en la Clínica La Asunción-ASSBASALUD de Manizales durante 2007. Métodos Estudio descriptivo de corte transversal en 310 niños entre 6 y 71 meses de la clínica La Asunción en el primer nivel de Manizales. Se evaluó la prevalencia de ferropenia en los niños y la aplicación de AIEPI para su prevención, diagnóstico y tratamiento por los profesionales de la salud responsables de la atención en ese centro. Resultados La mayoría de los niños tenía menos de 24 meses, era de SISBEN 2, fue atendida en Crecimiento y Desarrollo y por personal de enfermería. Entre la población afectada por ferropenia, el déficit de hierro sin anemia fue el que prevaleció. En la mitad de la población que tenía anemia, ésta se debió a déficit de hierro; la prevalencia de anemia de otro tipo fue superior a la de la anemia asociada con infección. Por cada niño con anemia ferropénica se presentaron casi tres con déficit de hierro. Sólo seis acompañantes de los niños estudiados refirieron haber recibido indicaciones dietarias para la prevención de la anemia y en la mitad de los casos, ésta fue errada. Conclusión Se evidenció que durante la atención de los menores de cinco años los procesos dirigidos a la prevención, diagnóstico y tratamiento de la anemia ferropénica no siguen los lineamientos estipulados por la estrategia AIEPI.

Objective Evaluating implementing the integrated management of childhood illness (IMCI) strategy in the prevention, detection and treatment of iron deficiency in children aged less than 5 who were treated at ASSBASALUD's Clinica La Asunción in Manizales, Colombia, during 2007. Methods This was a cross-sectional study of 310 children aged 6 to 71 months who attended the first-level Clinica La Asunción in Manizales. Iron deficiency prevalence was evaluated in the children, as was IMCI implementation for prevention, diagnosis and treatment by health professionals responsible for child-care at that centre. Results Most children were aged less than 24 months, came within category 2 in the Identification and Classification System for Potential Beneficiaries for Social Programmes (SISBEN) and had been treated by Growth and Development section nurses. Children suffering from iron deficiency without anaemia accounted for most of those affected by iron deficiency. In half the population suffering anaemia this was due to iron deficiency; anaemia prevalence was higher than other types of infection-associated anaemia. For every child suffering iron deficiency-related anaemia, almost three had iron deficiency. Only six people accompanying the children being studied said that they had received indications for the dietary prevention of anaemia and this was wrong in half of the cases. Conclusion These results showed that when caring for children aged less than five, prevention, diagnosis and treatment of iron deficiency anaemia did not follow the guidelines provided by the IMCI strategy.

Prevalence of Anaemia, Deficiencies of Iron and Folic Acid and Their Determinants in Ethiopian Women.

A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR)=1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR=0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR=0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micronutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses.

Iron Intake and Iron Deficiency Anaemia among Young Women in Kuala Lumpur

Objective: To assess the prevalence of iron deficiency, anaemia and iron deficiency anemia (IDA) in women aged 20 to 40 years and its association with iron intake. Methods: A total of 388 women were recruited from universities and work sites in Kuala Lumpur and its suburbs. The subjects comprised 135 Malays, 130 Chinese and 123 Indians. Dietary intake was estimated using a single 24-hour food recall and a semi-quantitative food frequency questionnaire. HAemoglobin (Hb), Haematocrit (hct), mean corpuscular volume (MCV) and serum ferritin were determinated. Results: The prevalence of anaemia (Hb <12g/dL) was 20.9%,being highest among the Indians (26.4%) and lowest among the Malays (16.4%). About 10.3% of the women showed iron deficiency anaemia (IDA) (Hb<12g/dL + serum ferritin <15mg/L + MCV < 80fl/). The prevalence of IDA was highest in Indians (18.0%) followed by Chinese (9.9%) and Malays (4.3%). The mean (95% CI) intake of total iron was at 14.4mg/day (95% CI 13.4, 15.5), amounting to 49.7% of the Malaysian recommended nutrient intake (RNI). Intake of Iron was the highest for the Indians (16.0mg/d) and the lowest for the Chinese (11.3mg/d). Conclusions: The overall prevalence of IDA was lower compared to prevalence of anaemia. Nonetheless, the markedly higher prevalence of IDA among the Indians, despite relatively higher intake levels of iron-rich foods warrants further investigations, including the bioavailability of iron in the context of cultural practices that may influence food preferences and meal preparation

Fatores de risco para deficiência de ferro entre crianças atendidas em ambulatório de hospital universitário: orientação nutricional e prevenção da anemia / Risk factors for iron deficiency in infants assisted in the clinic of a university hospital: nutritional education and prevention of anemia

The growth of infants is very fast over the fi rst two years of life and isinfl uenced by different factors. One of them is an adequate nutrition withbalanced amounts of macronutrients and micronutrients like organiciron. Iron deficiency may cause immediate and future alterations,thus jeopardizing the infantïs life quality. Many strategies are proposedto control the mineral defi ciency and one of the preventive actions isnutritional education to the breastfeeding infant?s mother. The aim ofthis study was to determine the prevalence of iron defi ciency and relatedfactors among infants aged 6 to 24 months assisted in the Pediatric Serviceof the Clinic Hospital at Federal University of Paraná (APP-HCUFPR).Nutritional Education actions are carried out by medical graduates andundergraduates in the hospital. The objective is an adequate infant diet,thus preventing iron defi ciency and iron-defi ciency anemia. The presentwork is a cross-sectional study which measured hemoglobin concentrationin 229 infants and serum ferritin (SF) in 180 infants (with the samecharacteristics of the overall sample). Anemia (hemoglobin concentration< 11.0g/dL) was detected in 44.6% of the infants, being statisticallyassociated with: infants with weight/age < the 5th percentile, infants aged6-12 months, mothers who attended school during 4 years or less, infantsborn after 37-39 weeks of gestation, breastfeeding more than 4 times aday, prenatal care outside APP-HCUFPR, infants living with more than 4people at home. Iron defi ciency (SF< 10mg/dL) was detected in 52.8% ofthe infants and was found to be high both in the fi rst and in the secondyear of life. In conclusion, nutritional education for an adequate dietalone was not enough to control nutritional iron defi ciency.

El crecimiento infantil acontece aceleradamenteen los primeros años de vida del niño y sufreinfl uencia de diferentes factores. Entre estos, lanutrición adecuada y equilibrada de macro ymicro nutrientes, como el hierro. La defi ciencia dehierro puede ocasionar alteraciones inmediatasy futuras, comprometiendo la calidad de vidadel niño afectado. Muchas son las estrategiaspropuestas para el control de la defi ciencia delmineral y una de las acciones de prevención esla orientación nutricional para las madres y loslactantes. El objetivo de este estudio fue determinarla prevalencia de defi ciencia de hierro, y los factoresasociados a ella, entre niños de 6 a 24 meses, delambulatorio de Pediatría Preventiva del HospitalClínicas de la Universidad Federal de Paraná(APP-HCUFPR). En este local son realizadasacciones de Educación Nutricional por graduadosy posgraduados de medicina. El objetivo es unadieta infantil adecuada, previniendo la defi cienciade hierro y la anemia ferropriva. El delineamientode estudio fue transversal, determinándose laconcentración de hemoglobina en 229 niños y laferritina sérica (FS) en 180 de ellos (con las mismascaracterísticas de la muestra global).Fue observadaanemia (concentración de hemoglobina < 11,0g/dL)en 44,6% de los niños, que está estadísticamenteasociada a: niños de peso/edad con percentil < 5;de 6 a 12 meses de edad; de madres con 4 o menosaños de estudio; nacidos de embarazos de edadgestacional de ?37- <39 semanas; con frecuenciade lactancia materna más de 4 veces al día; conprenatal realizado fuera del Servicio HC y viviendocon más de 4 personas en la misma casa. Ladefi ciencia de hierro (FS < 10mg/dL) fue observadaen 52,8% de los niños, siendo elevada tanto enel primero como en el segundo año de vida delniño.

O crescimento infantil se faz aceleradamente nosdois primeiros anos de vida da criança e sofrea infl uência de diferentes fatores. Um deles é anutrição adequada e equilibrada de macro emicronutrientes, como o ferro. A defi ciência deferro pode ocasionar alterações imediatas e futuras,comprometendo a qualidade de vida da criançaafetada. Muitas são as estratégias propostas parao controle da defi ciência do mineral e uma dasações de prevenção é a orientação nutricional paraas mães dos lactentes. O objetivo deste estudo foideterminar a prevalência da defi ciência de ferro,e os fatores a ela associados, entre crianças de 6 a24 meses, do Ambulatório de Pediatria Preventivado Hospital de Clínicas da Universidade Federal doParaná (APP-HCUFPR). Neste local, são realizadasações de Educação Nutricional por graduandose pós-graduandos de medicina. O objetivo é umadieta infantil adequada, prevenindo a defi ciênciade ferro e a anemia ferropriva. O delineamento doestudo foi transversal, determinando-se o nível daconcentração de hemoglobina em 229 criançase a ferritina sérica (FS) em 180 delas (com asmesmas características da amostra global).A anemia (concentração de hemoglobina< 11,0g/dL) foi observada em 44,6% das crianças,estando estatisticamente associada a: crianças depeso/idade com percentil < 5; com 6 a 12 mesesde idade; de mães com 4 ou menos anos deestudo; nascidas com idade gestacional entre 37 e39 semanas; com freqüência de aleitamentomaterno >4 vezes ao dia; com pré-natal realizadofora do Serviço HC e morando com > 4 pessoas namesma casa. A defi ciência de ferro (FS < 10mg/dL)foi observada em 52,8% das crianças, estandoelevada tanto no primeiro como no segundo anode vida da criança. Concluiu-se que a orientaçãonutricional sistemática, dentro do programa deatenção integral da criança, para uma dietaalimentar adequada, isoladamente, não foisufi ciente para controlar o défi cit nutricional deferro.

Anemia ferropriva no grupo infantil de uma comunidade rural da Zona da Mata Mineira: prevalência, fatores de riscos e avaliação do tratamento / Iron-deficiency anemia in a group of children in a rural community in the region of Zona da Mata, state of Minas Gerais: prevalence, risk factors and treatment evaluation

The objectives of this work were verifying the prevalence and risk factors for iron-defi ciency anemia in a group of children living in a rural communityand evaluating the treatment of anemic individuals. This is a serial prosssectional study of prevalence which assessed 51 children under 5 years old (45.5%). The data were obtained through questionnaires applied at home and the hemoglobin dosage was detected by a portable hemoglobin meter. The prevalence of anemia among the children was 58.8%. Most of the population presented per capita income of less than half the minimum wage, low level of education among adults and unsatisfactory sanitary conditions of homes. The treatment increased hemoglobin levels and decreased anemia among children to 46.1%. The results demonstrate the vulnerability of children to anemia, indicating the importance of carrying out educational activities in several sectors in order to allow the improvement in the social and economical standards of the families and to guide the population in the choice of a healthy nutrition enriched with iron, thus minimizing the risk factors for the development of anemia.

Los objetivos del trabajo fueran verificar la prevalencia y factores de riesgo para anemia por defi ciencia de hierro en el grupo infantil de una comunidad rural y evaluar el tratamiento propuesto a las personas con anemia. Estudio transversal de prevalencia en el cual que fueranevaluados 51 niños < 5 anos (45,5%). Los datos fueran colectados por cuestionario domiciliar y la determinación de hemoglobina por medio de unmedidor de hemoglobina portátil. La prevalencia de anemia en los niños fue 58,8%. La mayoría de la población presentó renta per cápita inferior a medio salario mínimo, baja escolaridad entre los adultos y las casas en condiciones sanitarias defi cientes. El tratamiento aplicado aumentóla concentración media de hemoglobina y disminuyó la prevalencia de anemia en los niños para 46,1%. Los resultados mostraron que elgrupo infantil es vulnerable a la ocurrencia de anemia, indicando la importancia del desarrollo de actividades de educación nutricional yacciones intersectoriales que permitan la mejoría del nivel socio-económico de las familias, visando estimular y enseñar la población en la elección de una alimentación saludable y fortifi cada en hierro y con eso, disminuir los factores de riesgo para el desarrollo de la anemia.

Os objetivos deste trabalho foram verifi car a prevalência e fatores de risco para anemia ferropriva no grupo infantil de uma comunidaderural e avaliar o tratamento oferecido aos indivíduos anêmicos. Estudo transversal de prevalência seriado no qual foram avaliadas 51 crianças < 5 anos (45,5%). Os dados foram coletados por inquérito domiciliar e a dosagem de hemoglobina através de hemoglobinômetro portátil. A prevalência de anemia nas crianças foi 58,8%. A maioria da população apresentou renda per capita inferior a meio salário mínimo, baixa escolaridade entre os adultos e os domicílios possuíam condições sanitárias insatisfatórias. O tratamento realizado aumentou a médiade hemoglobina e diminuiu a prevalência de anemia nas crianças para 46,1%. Os resultados demonstram a vulnerabilidade do grupo infantil à ocorrência de anemia, indicando a importância do desenvolvimento de atividades de educação nutricional e ações intersetoriais que permitam a melhoria do nível socioeconômico das famílias, visando incentivar e orientar a população na escolha de uma alimentação saudável e reforçada em ferro e com isso, minimizar os fatores de risco para o desenvolvimento da anemia.