Comparison of knowledge, attitude and practice of urban and rural households toward iron deficiency anemia in three Provinces of Iran

Lack of nutritional knowledge is one of the most important reasons of nutritional problems and consequently improper practice, which can lead to several complications. This study has been designed in order to compare knowledge, attitude and practices of the urban and rural households regarding iron deficiency anemia [IDA] in Boushehr, Golestan and Sistan and Balouchestan provinces in 2004. The sampling method at household's level in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household. Comparison of frequency of variables between urban and rural areas were tested by chi square test. A total of 2306 households were selected as overall sample size. In urban areas, people recognized iron food sources better than rural areas. Knowledge level of respondents about vulnerable group for IDA and the favorite attitude of households toward IDA were better in urban areas of Sistan and Blouchestan and Golestan provinces. In Sistan and Balouchestan and Golestan, rural households who drank tea immediately before or after meal was more than urban ones. The majority of pregnant and lactating mothers [except for rural areas of Bushehr] did not take iron supplement regularly. Less than 60 percent of children used iron drop regularly. Knowledge, attitude, and practice levels of households toward IDA were not acceptable. One of the best ways of improving nutritional practice is nutritional education with focus on applying available food resources

[Current status and the 10 years trend in the malnutrition indexes of children under 5 years in Iran]

Malnutrition is one of the main nutritional problems among children under 5 years especially in developing countries. The effects of malnutrition in this range of age group includes; disorder of mental and physical growth and development, increase in the morbidity and mortality, decrease of the learning capacity. A detailed epidemiological picture of the prevalent malnutrition status among children under 5 years in different regions of Iran enables health policy makers to identify priorities, establish political commitment and design appropriate interventional programs to prevent and control malnutrition and improve nutritional status of children. To determine the prevalence rate of malnutrition among children under 5 years. Demographic data, weight and height of 34200 Iranian children between 0-72 months old in 28 provinces of the country in 2005 year based on a cluster sampling were gathered. The subjects' weight and height were measured by trained staff. Prevalence of underweight, stunting, and wasting indicators was determined by measuring the weight and height of subjects in urban and rural areas. EPI6 statistical software, version b6/04, was used for all statistical analyses. 4.7% of the children aged less than five years suffered from stunting [95% CI: 4.5- 4.9%] the prevalence of this type of malnutrition among urban children is significantly less than rural children [95% CI: 3.1- 3.5% and 6.5-7.1% respectively]. Meanwhile the prevalence of underweight was 5.2% in the country [95% CI: 5.1-5.4%] while the prevalence of this type of malnutrition was significantly less among urban children than those in rural ones. Moreover, the prevalence of wasting was 3.7% [95%CI: 3.5-3.9%] and there was a significant difference in this regard between the urban and rural children. Thus this indicator was significantly higher among urban children than those in rural areas [95%CI: 3.8-4.3% and 3.0-3.5% respectively]. The results of the study show that the prevalence of protein-energy malnutrition was low among Iranian children under five years old. In comparison with previous studies, it is felt that there has been a prudent decrease in all malnutrition in all levels. However, there were significant differences in the prevalence of malnutrition in different provinces, which has resulted in the differences in their developmental stages as well. It appears that subjective strategies are required to improve the nutritional and health status among children under five in all provinces

Prevalence of anaemia in 2-12- year-old Iranian children

Haemoglobin levels were used to estimate the prevalence of anaemia in children 2- 12 years old in the Islamic Republic of Iran. The study was part of the National Health and Disease Survey in 1999 that used a cluster sample of 1 in 1000 of the Iranian population. Of 4170 children aged 2- 6 years, 7.3% were diagnosed with mild anaemia, 2.5% moderate anaemia and 1.0% severe anaemia [WHO definitions]. Of 8461 children aged 7- 12 years, 10.9% were diagnosed with mild anaemia, 3.0% moderate anaemia and 1.1% severe anaemia. The prevalence of anaemia was significantly higher in rural than urban areas

Managing nutritional programmes in developing countries

Improving community nutrition in developing countries requires a detailed epidemiological picture of the prevalent nutritional problems in different regions and age groups. This makes it possible to identify priorities, sensitize policy-makers, establish political commitment and design appropriate community programmes for income generation and education for the best use of food resources. Experiences acquired from community-based nutritional programmes show that ownership of a programme by the community and using a tailor-made approach are essential factors in the successful implementation of programmes. A multifaceted approach is needed, involving a range of sectors-agriculture, commerce, education and health-- and commitment at all levels from government to communities and individuals

Multidisciplinary intervention for reducing malnutrition among children in the Islamic Republic of Iran

A multidisciplinary intervention to reduce protein-energy malnutrition among children in rural areas was piloted in 3 provinces of the Islamic Republic of Iran. Based on an initial situation analysis, a range of interventions were implemented through local nongovernmental organizations, including nutrition, health and literacy education for mothers, improved growth monitoring and fostering rural cooperatives and income generation schemes. Malnutrition before and after the intervention [in 1996 and 1999] was assessed using anthropometric measurements of r and om samples of children aged 6-35 months in control and intervention areas. Three years into the intervention, all indicators of malnutrition had consistently decreased in all intervention areas and the prevalence of underweight and stunting was significantly lower. Control areas showed a mixed pattern of small increases and decreases in malnutrition indicators

Community-based nutritional intervention for reducing malnutrition among children under 5 years of age in the Islamic Republic of Iran

A project was conducted in a rural area in September 1994 with the aim of decreasing the incidence of protein-energy malnutrition among children under 5 years, by nutritional intervention through the primary health care system. An initial situation analysis revealed the region's resources and causes of malnutrition. Practical instruction on feeding methods, deworming, environmental sanitation, the promotion of home-grown vegetables and reinforcement of the growth monitoring programme were chosen as the routes for intervention. All indices were reassessed in the region after 1 year. Results showed that nutritional awareness had grown among mothers, and that the incidence of malnutrition had dropped from 6.5% to 1.8%, as measured against the weight-for-height index

Iron deficiency anemia and energy and nutrient intakes in 14-18 year old high school girls in the South of Tehran

The purpose of this study was evaluation of iron status as well as protein and iron intakes in 14-18 year old girls in high schools in the south of Tehran. A total of 268 girls were chosen at random for a dietary survey using the 24-hr dietary recall method and the biochemical tests were made on 109 of the girls. The results indicate that: compared with the WHO standards, hemoglobin in 0.9%, hematocrit in 2.8% and MCHC in 13.8% of the girls were lower than the respective standards, and TJBC in 33.9% of the girls was high. Altogether, 86.6% of the girls had a low energy intake, 45% a low protein intake and 52% a low iron intake. A low intake of iron, mostly of plant origin, with its low bioavailability, is the most important factors in iron deficiency anemia in these girls