Anemia and iron deficiency among schoolchildren in the Aral Sea region, Kazakhstan

Biological (microfloral) factors of influence on cytogenetic stability during chemical mutagenesis

The article presents the results of a study of chromosomal mutations in residents living in the Aral Sea disaster zone. The present study was designed to evaluate the impact of the combined effect of a chemical mutagen (nickel) and bacterial microflora on the level of chromosomal aberrations (CA) in peripheral blood lymphocytes. This study used classical methods of cell cultivation, methods for determining chromosomal aberrations, a cytomorphological method for assessing epithelial cells, and an atomic absorption method for determining trace elements in the blood. The article shows that with an increase of chemical agent in the blood, the number of cells with features of damage and cells with contamination by microflora increases. Both of these factors cause an increase in the frequency of chromosomal aberrations. The article demonstrates how being exposed to a chemical factor increases chromosomal mutations, and also damages membrane components, which leads to a decrease in the barrier and protective function of the cell, and as a result also affects the level of chromosomal aberrations.

The pattern of iron deficiency with and without anemia among medical college girl students in high altitude southern Saudi Arabia

Introduction:

The prevalence of iron deficiency, latent and symptomatic, is heterogeneous worldwide. In this study, we aim to explore the prevalence of iron deficiency, with and without anemia, among medical college females at the high Altitude Aseer region of Southwestern Saudi Arabia.

Methodology:

200 female medical students were randomly sampled, between the ages of 19 and 27 years. Blood samples were collected for complete blood count (CBC) values and serum ferritin determination. Questionnaires were completed in order to collect demographics, medical history, and socioeconomic information of the participants.

Results:

Prevalence of overall iron deficiency was high (63%, serum ferritin <20 μg/L, 52.5%, ferritin <15 μg/L). Anemia, adjusted for high altitude (defined as less than 13 g/dL was present in 41 participants (20.5%) and 12 (6.5%) have Hb <12 g/dL. Iron-deficiency anemia (Hb <13 g/dL and serum ferritin <15 μg/L) was present in 35 (17.5%). Personal and family history of anemia and poor animal product containing meals were positively correlated with the presence of iron deficiency state. Neither symptoms of anemia, nor the presence of menorrhagia correlate with the presence of iron deficiency anemia.

Conclusion:

Iron deficiency with and without anemia is a very common and condition in young females’ population at high altitude. Implementing a lab method to screen for anemia on vulnerable populations is needed. Frequently asymptomatic, the primary care providers should maintain a high degree of suspicion in order to initiate screening for iron status.

Prevalence of Iron Deficiency Anemia among University Students in Hodeida Province, Yemen

Background

Iron deficiency anemia (IDA) is one of the most common types of nutritional anemia in the worldwide and considered a major public health problem in developing countries especially in Yemen. Therefore, this cross-sectional study was conducted to determine the prevalence and risk factors of IDA among apparently healthy Yemeni students at Hodeida University.

Method

Five hundred blood samples (326 males and 174 females) were collected randomly from medical students at Hodeida University. Participants were subjected to different tests including complete blood counts (CBC), serum ferritin (SF), serum iron (SI), and total iron binding capacity (TIBC). Moreover, a questionnaire was designed to collect demographics, food and drink habits, and socioeconomic status.

Result

The overall prevalence of IDA was 30.4%  (n = 152), of whom 54.00% were females (n = 82) and 46.0% were males (n = 70). Students aged 20–22 years were found more anemic with prevalence 59.2% than students aged 17–19 years (25.0%) and 23–25 years (15.8%). Statistical analysis showed regularly having breakfast had significant (p < 0.001) role in preventing development of IDA compared with irregularly having breakfast. Infrequent consumption of vegetables/fruits; meat, fish, chicken; tea drinking; low household income; smoking and khat (Catha edulis) chewing showed a significant role (p < 0.001) in provoking of IDA, whereas consumption of coffee and cola showed insignificant influence (p = 0.585; p = 0.513) on IDA.

Conclusion

This study revealed that the majority of university students, especially females, have IDA that might become worse by malnutrition, lifestyle habits, and lack of awareness. Our results suggest that IDA can be prevented by providing proper knowledge on the healthful diet, improved lifestyle, and harmful effect of IDA to the students.

Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011-2012

BACKGROUND

Iron deficiency Anemia (IDA) in children is a recognized public health problem that impacts adversely on child morbidity, mortality and impairs cognitive development. In Pakistan information on the true prevalence and predictors of IDA is limited. This study sought to investigate IDA in children under five years of age using data from a nationally representative stratified cross-sectional survey.

METHODS

Secondary analysis was performed on the National Nutrition Survey in Pakistan 2011-2012. We used a pre-structured instrument to collect socio demographic and nutritional data on mothers and children. We also collected Anthropometric measurements and blood samples for micronutrient deficiencies. IDA was defined as having both haemoglobin levels of <110 g/L and ferritin levels of < 12 μg/L. Data analysis was performed by applying univariate and multivariate techniques using logistic regression through SPSS.

FINDINGS

A total of 7138 children aged between 6-59 months were included in the analysis. The prevalence of IDA was 33.2%. In multivariate regression analysis adjusted odds ratios (AOR) were calculated. Age < 24 months (AOR 1.40, 95% CI 1.18-1.55 p <0.05), stunting (AOR 1.42 CI 1.23-1.63 p<0.05), presence of clinical anemia (AOR 5.69 CI 4.93-6.56 p<0.05), having a mother with IDA (AOR 1.72 CI 1.47-2.01 p<0.05) and household food insecurity (AOR 1.20 CI 1.10-1.40 P<0.05) were associated with IDA. Living in a rural area (AOR 0.77 CI 0.65-0.90 p<0.05) and being a female child (AOR 0.87 CI 0.76-0.98 p<0.05) were associated with reduced odds of IDA.

CONCLUSION

The prevalence of IDA amongst Pakistani children represents a moderate burden that disproportionately affects the youngest, growth retarded children, affected children are more likely to have mothers with IDA and live in areas where food security is lacking. National efforts to alleviate the burden of IDA should involve both short term vertical programs such as iron supplementation and long term horizontal programs including wheat flour fortification.

Ferritin Levels in Colombian Children: Findings from the 2010 National Nutrition Survey (ENSIN)

Low ferritin is associated with many adverse health outcomes and is highly prevalent worldwide. The aim of this study was to describe the key findings related to plasma ferritin levels to identify the prevalence and associated sociodemographic factors in a representative sample of children in Colombia, based on the 2010 National Nutrition Survey. We analyzed cross-sectional data from 6650 Colombian children between the ages of 5 and 12. Plasma ferritin levels were determined by chemiluminescence. Sociodemographic data was assessed by computer-assisted personal interview technology. All analyses were conducted considering the complex nature of the sample. Of the children assessed, 3.5% had low ferritin, defined as levels <12 µg/L. A multivariate logistic regression analysis revealed increased risks for low ferritin levels among black or Afro-Colombian ethnic group and for those living in the northern, western and southern regions of the country. In conclusion, a significant prevalence of anemia caused by low ferritin levels was found and various sociodemographic factors were associated with this finding in Colombia. Continued surveillance and implementation of interventions to improve dietary patterns among the identified high-risk groups should be considered. Implementing these recommendations can help reduce manifestations of iron deficiency (e.g., delays in infant and child development) and thus improve public health.

Nutritional iron deficiency anemia: magnitude and its predictors among school age children, southwest Ethiopia: a community based cross-sectional study

BACKGROUND

Iron deficiency anemia (IDA) is a global public health problem among school age children, which retards psychomotor development and impairs cognitive performance. There is limited data on prevalence and risk factors for IDA.

OBJECTIVE

The aim of this study was to determine the prevalence, severity, and predictors of nutritional IDA in school age children in Southwest Ethiopia.

METHODOLOGY

A community based cross-sectional study was conducted in Jimma Town, Southwest Ethiopia from April to July 2013. A total of 616 school children aged 6 to 12 years were included in the study using multistage sampling technique. A structured questionnaire was used to collect sociodemographic data. Five milliliter venous blood was collected from each child for hematological examinations. Anemia was defined as a hemoglobin level lower than 11.5 g/dl and 12 g/dl for age group of 5-11 years and 12-15 years, respectively. Iron deficiency anemia was defined when serum iron and ferritin levels are below 10 µmol/l and 15 µg/dl, respectively. Moreover, fresh stool specimen was collected for diagnosis of intestinal parasitic infection. Stained thick and thin blood films were examined for detection of Plasmodium infection and study of red blood cell morphology. Dietary patterns of the study subjects were assessed using food frequency questionnaire and anthropometric measurements were done. Data were analyzed using SPSS V-20.0 for windows.

RESULT

Overall, prevalence of anemia was 43.7%, and that of IDA was 37.4%. Not-consuming protein source foods [AOR = 2.30, 95%CI(1.04,5.14)], not-consuming dairy products [AOR = 1.83, 95%CI(1.14,5.14)], not-consuming discretionary calories [AOR = 2.77, 95%CI(1.42,5.40)], low family income [AOR = 6.14, 95%CI(2.90,12.9)] and intestinal parasitic infections [AOR = 1.45, 95%CI(1.23, 5. 27)] were predictors of IDA.

CONCLUSION

Iron deficiency anemia is a moderate public health problem in the study site. Dietary deficiencies and intestinal parasitic infections were predictors of IDA. Therefore, emphasis should be given to the strategies for the prevention of risk factors for IDA.

Iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza Strip, Palestine

BACKGROUND

iron deficiency anemia is the most common type of nutritional anemia; it has been recognized as an important health problem in Palestine. This study was conducted to estimate the prevalence and to identify possible risk factors of iron deficiency anemia among kindergarten children living in the marginalized areas of the Gaza Strip and to evaluate the effectiveness of supplementing oral iron formula in the anemic children.

METHODS

the study included 735 (384 male and 351 female) kindergarten children. Data was collected by questionnaire interviews, anthropometric measurements, and complete blood count analysis. All iron deficient anemic children were treated using an oral iron formula (50 mg ferrous carbonate + 100 mg vitamin C /5 mL) and the complete blood count was reassessed after three months. A univariate analysis and a multiple logistic regression model were constructed; crude and adjusted odds ratios (OR), and 95% confidence intervals (95% CI) were calculated.

RESULTS

the overall prevalence of iron deficiency anemia was 33.5% with no significant differences between boys and girls. Significantly different prevalences of iron deficiency anemia were reported between different governorates of the Gaza Strip. Governorate, low education level of the parents and smoking are significant risk factors for children developing anemia. Significantly lower complete blood count parameters, except for WBC, were reported in anemic children. The oral iron treatment significantly improved hemoglobin concentrations, and normalized the iron deficiency marker.

CONCLUSIONS

iron deficiency anemia is a serious health problem among children living in the marginalized areas of the Gaza Strip, which justifies the necessity for national intervention programs to improve the health status for the less fortunate development areas.

Gestational iron deficiency and the related anaemia in northern zone of Ebonyi State

Iron is one instrumental micronutrient to any healthy pregnancy. Its deficiency (with or without overt anaemia) remains a significant risk factor to gestational complications. In the present study, 307 pregnant women were prospectively recruited from Northern zone of Ebonyi State to assess their gestational iron status. The iron status of the subjects was determined with serum iron level and heamoglobin concentration, using atomic absorption (flame) spectrometric and Drabkin's methods respectively. Statistical analysis was performed using the computer software: "Statistical Program for Social Sciences" (SPSS for windows version 15.0). The result showed that 177 (59.8%) of the pregnant women were iron deficient, while 45.6% of them was at the risk of iron deficiency anaemia. Parity, educational level, occupation and living accommodation showed significant (p < 0.05) influence on the iron status of the subjects. It could be concluded that gestational iron deficiency with its related anaemia was yet to be effectively brought under control in our society; with parity and economic status implicated as risk factors.

Iron deficiency among non-anemic under-five children in enugu, South-East, Nigeria

Background:

Iron deficiency has been described as the world most common nutritional deficiency and the commonest cause of nutritional anemia in infancy and childhood. The deleterious behavioral and cognitive deficit associated with iron-deficiency anemia could be irreversible. Therefore, the latter should be prevented by early detection of iron deficiency in the non-anemic groups.

Aim:

To determine the prevalence of iron deficiency in the non-anemic under-five children and to document its variation among the age classes of these children.

Subjects and Methods:

Under-five children presenting at a tertiary hospital were consecutively enrolled, Serum ferritin levels of the subjects were used to assess the iron status and serum ferrritin level of less than 12 ng/ml was considered as iron deficiency. Data were analyzed using SPSS version 15.0. Chi-square tests were employed as necessary for test of significance in each of the characteristics of the population at P ≤ 0.05.

Results:

A total of 178 non anemic under-five children were studied, their mean hematocrit and serum ferrritin values were 35.5 (2.8%) and 54.9 (76.1) ng/ml respectively. Forty-nine (27.5% [49/178]) of the study population was iron deficient and there was no significant difference in the prevalence of iron deficiency among the age classes (P = 0.75).

Conclusion:

This study has documented a high prevalence of iron deficiency in non-anemic under-five children presenting at the outpatient department and emergency room of a tertiary health facility in Enugu. All the age classes were relatively affected. A further research into the causes of iron deficiency in this age group is recommended.

Anemia and Related Factors in Preschool Children in the Southern Rural Lao People's Democratic Republic

Anemia is a severe public health problem in the Lao People's Democratic Republic (PDR). Consequently, a new control strategy to reduce the burden of anemia has been introduced for preschool children (aged 6-52 months). The objective of this study was to assess the current prevalence of anemia and related factors in preschool children in southern rural Lao PDR. A population-based cross-sectional study was carried out in six communities in Songkhone district, Savannakheth province, in February 2009. As a result, the prevalence of anemia was found to be 48.9% (95% confidence interval (CI), 43.5-54.3), although most cases were mild. A multiple logistic regression analysis indicated that there was no protective effect of breastfeeding against anemia. The anemia prevalence was higher in 1) children aged 6-23 months (Odds Ratio (OR) = 1.73, 95% CI, 1.02-2.90) than in older children, 2) children in large families (6 or more members) (OR = 1.96, 95% CI, 1.17-3.29), and 3) children in three remote villages with relatively difficult access to markets (OR = 3.01, 95% CI, 1.25-7.47).In Lao PDR, improvement of food practices and home-fortified food supplementation interventions are essential. High-risk groups should be targeted and a long-term health education program that aims to modify food habits implemented. Furthermore, in settings where iron deficiency is not the only cause of anemia, combining an iron supplement with other measures is necessary.

Anemia and iron deficiency in adolescent school girls in kavar urban area, southern iran

BACKGROUND

Anemia is one of the most common public health problems especially in developing countries. We investigated the prevalence of anemia, iron deficiency anemia and related risk factors in adolescent school girls in Kavar urban area in southern Iran.

METHODS

A total of 363 adolescent school girls were evaluated by a cross sectional study. Socioeconomic, demographic and related risk factors were obtained by a questionnaire. Hematological parameters and serum iron indices were measured.

RESULTS

There were 21 cases of anemia (5.8%), 31 (8.5%) iron deficiency and 6 (1.7%) iron deficiency anemia.  Most of anemic girls (85.7%) had mild anemia.  MCV, TIBC, age, and BMI had statistically significant relationship with hemoglobin. Only parasites infestation in the last three months had a 6.83 times more risk of anemia than those without this history (95% CI, 1.66-28.11).

CONCLUSION

The prevalence of anemia and iron deficiency anemia in this study were substantially less than what reported in many other regions of Iran as well as other developing countries. It seems that related implemented strategies in the recent years have been successful. More especial attention to prevention of parasite infestation should be considered in this area.

What have we learned? A review of the literature on children's health and the environment in the Aral Sea area

Objectives

To review the published literature examining the impacts of the Aral Sea disaster on children’s health.

Methods

A systematic review of the English language literature.

Results

The literature search uncovered 26 peer-reviewed articles and four major reports published between 1994 and 2008. Anemia, diarrheal diseases, and high body burdens of toxic contaminants were identified as being among the significant health problems for children. These problems are associated either directly with the environmental disaster or indirectly via the deterioration of the region’s economy and social and health care services. While links between persistent organic pollutant exposures and body burdens are clear, health impacts remain poorly understood. No clear evidence for the link between dust exposure and respiratory function was identified.

Conclusion

While important questions about the nature of the child health and environment relationships remain to be answered, the literature unequivocally illustrates the seriousness of the public health tragedy and provides sufficient evidence to justify immediate action. Regrettably, international awareness of the crisis continues to be poor, and the level of action addressing the situation is wholly inadequate.

Nutritional Status of Primary Schoolchildren in Garhwali Himalayan Villages of India

Background

Anemia and micronutrient deficiencies are common among Indian schoolchildren. However, past studies have narrowly focused on only a few micronutrients and have not carefully evaluated the association between sociodemographic factors and nutritional status of schoolchildren.

Objective

To assess the nutritional status of schioolchildren in Himalayan villages of India and to determine the relationships between their nutritional status, intestinal helminth infection, and sociodemographic characteristics.

Methods

A random sample of 499 children 6 to 10 years of age from 20 public primary schools was selected. Household sociodemographic data and morbidity data on children were collected through interviews with their caretakers. Height and weight were measured, and venous blood was drawn for assessment of hemoglobin, serum ferritin, soluble transferrin receptor, retinol, zinc, folic acid, vitamin B12, and C-reactive protein. Stool samples were analyzed for parasitic infections.

Results

Underweight, stunting, and wasting were present in 60.9%, 56.1%, and 12.2% of schoolchildren, respectively. Anemia, iron-deficiency anemia, and low serum concentrations of ferritin, zinc, retinol, folate, and vitamin B12 were found in 36.7%, 10.2%, 24.1%, 57.1%, 56.1%, 67.9%, and 17.4% of the children, respectively. One-fifth of the children had intestinal parasites. Being underweight was associated with lower household wealth ( p < .05). Helminth infection was associated with stunting, anemia, and low serum retinol ( p < .05). Living at higher altitude was associated with low serum levels of ferritin, retinol, and vitamin B12. There were no associations between any sociodemographic variables and serum zinc or folate.

Conclusions

Growth impairment and micronutrient deficiencies are prevalent among schoolchildren in Himalayan villages of India.

Effectiveness of communication campaign on iron deficiency anemia in Kyzyl-Orda region, Kazakhstan: a pilot study

Background

In 2004, wheat flour fortification (WFF) with iron was implemented in Kazakhstan as a public health strategy to increase the iron intake of all women of childbearing age and of children. In 2003, before starting the flour fortification program, a communication campaign on health education took place in a region with a high prevalence of iron deficiency anemia (IDA). The present study aimed to evaluate the prevalence of anemia, iron deficiency and IDA before and after the campaign. In addition, knowledge about IDA and its prevention, as well as awareness about fortified wheat flour, was assessed.

Methods

The subjects of the study were women aged 15-49 years and children aged 2-14 years. The study was carried out in urban and rural areas of Kyzyl-Orda region in 2003 before (March) and after (December) the campaign. Blood samples were collected in order to measure hemoglobin and serum ferritin. In March 80 women and 57 children in the urban area, and 41 women and 41 children in the rural area, participated in the IDA testing. The corresponding participants in December numbered 62, 52, 52, and 57, respectively. The impacts of the communications and information received by participants during the campaign was surveyed with a questionnaire for 195 women in March and 198 women in December including some who participated in the IDA testing.

Results

In March, the prevalence of anemia was 52.0% among 121 women and 58.1% among 98 children, and those with low iron reserve were 63.6%, 49.1% and IDA 40.5%, 11.0%, respectively. In December, the prevalence of anemia had significantly decreased among rural women (from 65.9% to 48.0%, p < 0.05) and among urban children (from 63.1% to 11.5%, p < 0.001). The prevalence of iron deficiency was significantly reduced among the children (from 51.1% to 24.8%, p < 0.001). IDA prevalence was meaningfully decreased among women in urban and combined areas (from 37.5% to 15.0% and 40.5 to 14.8%, respectively, p < 0.001) and among urban children (from 7.1% to 2.1%, p < 0.05). The surveys found that most women knew about IDA and its prevention and that the numbers were similar both in March and in December. The knowledge of the anti-anemic effect of wheat fortified flour improved significantly over the period of the campaign among women both in urban (from 48.5% to 80.9%, p < 0.001) and rural (from 69.8% to 88.6%, p < 0.001) areas.

Conclusion

The study demonstrated that the communication campaign before implementation of WFF program was effectively carried out, giving a biological impact on hematological indices.

Concentrações de hemoglobina e ferritina sérica em escolares da rede pública municipal de Teresina, Piauí, Nordeste do Brasil

OBJETIVOS: avaliar o estado nutricional de ferro em escolares de instituições públicas de ensino de Teresina, Piauí, Brasil. MÉTODOS: corte transversal, envolvendo amostra aleatória, selecionada em duas etapas, de 747 escolares (7-11 anos), de ambos os sexos, no período de agosto / setembro de 2000. A anemia foi rastreada em 747 escolares e para o diagnóstico adotou-se a concentração de hemoglobina (Hb) <11,5g/dL. As reservas corporais de ferro foram estimadas em 207 escolares, mediante análise das concentrações de ferritina sérica (FerS), considerando-se baixas reservas valores <15 µg/L. RESULTADOS: a prevalência de concentrações inadequadas de Hb (< 11,5g/dL) foi de 14,3% (IC95% 12,2-17,4) e de reservas inadequadas de ferro (FerS< 15,0µg/L) de 20,3% (IC95% 15,2-26,6). A prevalência de anemia foi semelhante entre os sexos (p=0,60) e as faixas etárias (p=0,85). Comportamento distributivo similar foi observado no que diz respeito às reservas inadequadas de ferro, frentes às variáveis sexo (p=0,19) e idade (p=0,24). As concentrações de FerS não mostraram correlação (r=0,1; p=0,168) com as de Hb. A prevalência de anemia ferropênica (Hb< 11,5 g/dL e FerS< 15,0 µg/L) foi de 26,3% (IC95% 17,3-37,5). CONCLUSÕES: em Teresina, a deficiência de ferro e a anemia em escolares devem ser consideradas como um problema de saúde pública que requer efetivo programa de prevenção e controle. No entanto, a anemia parece não ser explicada apenas pela deficiência de ferro; outros fatores etiológicos devem, portanto, ser considerados, a exemplo da deficiência de outros micronutrientes, infecções/infestações parasitárias, distúrbios hereditários e exposição a poluentes ambientais.

The effects of iron deficiency on neutrophil/monocyte apoptosis in children

OBJECTIVES

Iron is essential for DNA synthesis; its deficiency may lead to impaired DNA synthesis and subsequent alterations in levels of apoptosis. Here, we have aimed to investigate effects of iron deficiency anaemia (IDA) on apoptotic response of phagocytic cells and to understand whether the effect is reversible after iron supplementation.

MATERIALS AND METHODS

Forty-nine IDA patients and 26 healthy controls, aged between 6 months and 12 years with similar demographic status, were considered. Neutrophil- and monocyte-apoptotic responses of IDA patients and the control group were compared by flow cytometry. Then, IDA patients were provided with oral iron supplementation. On day 15 of iron therapy, neutrophil- and monocyte-apoptotic responses of IDA patients were rechecked and were compared to those of control group.

RESULTS

Neutrophil- and monocyte-apoptotic responses in terms of early and late percentages of apoptosis, and percentages of necrotic cells, were significantly less in IDA patients compared to the control group. The significantly low apoptotic responses of IDA patients rose to levels of the control group by day 15 of iron therapy. Besides, the effect of IDA on apoptotic responses was found to be more enhanced in severe IDA patients that those of mild IDA patients.

CONCLUSION

Correction of differences after iron supplementation therapy implies that IDA might be a cause for changes in neutophil- and monocyte-apoptotic responses. The impact of this diminution of apoptotic cellular function in IDA should be further investigated, with longitudinal studies, in order to document the impact of any severe and/or long-lasting IDA on autoimmunity and malignancy.

Anaemia, iron deficiency and vitamin A status among school-aged children in rural Kazakhstan

OBJECTIVES

To investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population.

DESIGN

A cross-sectional design.

SETTING

School-aged children in rural Kazakhstan.

SUBJECTS

Socio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and beta-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured.

RESULTS

Among the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value < 1.05 micromol l(-1). Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis.

CONCLUSIONS

Anaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.

Respiratory symptoms and pulmonary function among school-age children in the Aral Sea region

The saline Aral Sea in central Asia was once the 4th largest inland lake in the world. Desiccation of the Aral Sea as a result of diversion of inflow for irrigation has resulted in significant adverse health effects among residents of surrounding areas. This study was conducted to examine respiratory symptoms and function among children who lived in "the heavily affected disaster zone" (i.e., within 200 km of the Aral Sea), by comparing them with children who lived in "the slightly affected disaster zone" (i.e., located approximately 500 km from the Aral Sea). A questionnaire-based interview was conducted among 383 students 6-15 yr of age who lived in the study area and 432 students who lived in the reference area. Pulmonary function tests were completed by 337 children in the study area and 417 children in the reference area. Prevalence of current cough and current wheezing was higher among the study group participants. Percentage of predicted forced vital capacity (FVC% predicted) was lower in the study group (median = 96.6%) than in the reference group (median = 100.5%), and prevalence of restrictive pulmonary dysfunction was higher in the study group (10.6%) than in the reference group (2.6%). Multivariate analysis indicated that FVC% predicted was lower among females and in the study area, but was not associated with socioeconomic factors.

Prevalence of iron deficiency among schoolchildren of different socio-economic status in urban Turkey

OBJECTIVE

To investigate the prevalence of iron deficiency among schoolchildren of different socio-economic status (SES), living in the three largest cities of Turkey.

DESIGN

Cross-sectional study.

SETTINGS

Primary schools of Istanbul, Ankara and Izmir.

SUBJECTS

Schoolchildren aged 12 and 13 y (males: 504; females: 510) from nine primary schools. Inclusion of subjects in the study was on a voluntary basis.

METHODS

Data were obtained on children SES, anthropometry, haematological and biochemical indices of iron status and consumption of food items related to dietary iron bioavailability. One-way analysis of variance was mainly applied, for the evaluation of the tested hypotheses, using Bonferroni correction in order to take into account the inflation of Type I error.

RESULTS

Iron deficiency (serum ferritin <15 microg/l) prevalence was 17.5% among boys and 20.8% among girls. Furthermore, iron deficiency was significantly more prevalent among boys of lower SES, who were also found to have significantly lower levels of serum iron, serum ferritin, transferrin saturation, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration compared to those of higher SES. In terms of dietary factors affecting iron bioavailability, low SES boys exhibited significantly higher frequency of tea consumption and lower frequency of citrus fruit, red meat and fish consumption, compared to their higher SES counterparts.

CONCLUSION

The prevalence of iron deficiency was relatively high, particularly among lower SES schoolboys. Higher tea and lower citrus fruits, red meat and fish consumption by boys of lower SES may provide an indication about the possible role of certain dietary patterns in the different manifestation of this medical condition among the socio-economic groups. However, further research is needed.