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Risk factors for iron deficiency anaemia in preschool children in northern Ethiopia

Published online by Cambridge University Press:  02 January 2007

AA Adish ,
SA Esrey ,
TW Gyorkos  and
T Johns
AA Adish*
Affiliation:
School of Dietetics and Human NutritionMacdonald Campus of McGill University, 21, 111 Lakeshore Road, St Anne-de-Bellevue, Quebec H9X 3V9, Canada Jimma Institute of Health Sciences, Ethiopia
SA Esrey
Affiliation:
School of Dietetics and Human NutritionMacdonald Campus of McGill University, 21, 111 Lakeshore Road, St Anne-de-Bellevue, Quebec H9X 3V9, Canada UNICEF, 3 UN Plaza, New York, NY 10017, USA Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
TW Gyorkos
Affiliation:
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada Division of Clinical EpidemiologyMontreal General Hospital, Montreal, Quebec, Canada
T Johns
Affiliation:
School of Dietetics and Human NutritionMacdonald Campus of McGill University, 21, 111 Lakeshore Road, St Anne-de-Bellevue, Quebec H9X 3V9, Canada
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

To determine risk factors for anaemia in preschool children.

Design

A cross-sectional study.

Setting

Tigray province, northern Ethiopia.

Subjects

2080 of 2373 children aged 6–60 months provided blood to assess anaemia.

Results

Anaemia was highly prevalent (42%) and constituted an important nutritional problem in the region. In a sub-sample of 230 anaemic children, 56% had a low red blood cell (RBC) count, and 43% had a serum ferritin of less than 12 μg l−1 indicating that the anaemia was largely due to iron deficiency. Unlike other regions in developing countries, hookworm (0.4%) and malaria (0.0%) were rare and contributed little to the anaemia. Even though their diet lacked variety, the amount of iron consumed through cereal-based staple foods was adequate. However, the iron in these foods was not readily available and their diets were probably high in iron absorption inhibitors and low in enhancers. Dietary factors associated with anaemia included frequent consumption of inhibitors, such as fenugreek and coffee, and poor health in the child such as diarrhoea and stunting.

Conclusions

Underlying causes of anaemia were lack of safe water and inadequate human waste management, maternal illiteracy and mother being ill, and having no food reserves. The root cause of these factors was poverty. The optimal control strategy for iron deficiency anaemia should have a holistic approach which includes the alleviation of poverty, the empowerment of women and the provision of a safe environment.

Keywords

AnaemiaIron deficiencyRisk factorsChildren
Type
Research Article
Information
Public Health Nutrition , Volume 2 , Issue 3 , March 1999 , pp. 243 - 252
Copyright
Copyright © CABI Publishing 1999

References

1United Nations, ACC/SCN. Controlling Iron Deficiency. Nutrition Policy Discussion, Paper No. 9. New York: United Nations, 1991.Google Scholar
2Hofvander, Y. Hematological investigations in Ethiopia with special to a high iron intake. Acta Med. Scand. 1968; 494: 11–74.Google Scholar
3Gebre-medhin, M, Kilander, A, Bahlquist, B, Wuhib, E. Rarity of anaemia of pregnancy in Ethiopia. Scand. J. Haematol. 1976; 16: 168–75.CrossRefGoogle ScholarPubMed
4Zein, ZA, Assefa, M. The prevalence of anemia among populations living at different altitudes in north-western Ethiopia. Ethiop. Med. J. 1987; 25: 105–11.Google ScholarPubMed
5Esrey, SA, Adish, AA, Barr, G, Asefa, T. Characteristics and Determinants of Nutritional Status in Tigray. IDRC report. Ottawa: IDRC, 1995.Google Scholar
6Gebreselassie, HM. Iron supplementation and malaria infection: results from a randomized controlled field trial. PhD thesis, McGill University, Montreal, Canada, 1997.Google Scholar
7Baker, SJ, DeMaeyer, EM. Nutritional anemia: its understanding and control with special to the work of the World Health Organization. Am. J. Clin. Nutr. 1979; 32: 368–417.CrossRefGoogle Scholar
8Food and Agriculture Organization (FAO). Requirements of Vitamin A, Iron, Folate and Vitamin B12. Report of a Joint FAO/WHO expert consultation. Rome: FAO/WHO, 1988.Google Scholar
9Cook, JD, Skikne, BS, Baynes, RD. Iron Deficiency: The Global Perspective. Progress in Iron Research. New York: Plenum Press, 1994: 219–28.Google Scholar
10Interdepartmental Committee on Nutrition for National Defense. Ethiopia – Nutrition Survey. Washington DC: US Government Printing Office, 1959.Google Scholar
11Ministry of Health of Ethiopia, MOH/WHO. Primary Health Care Review Ethiopia. Addis Abeba: Ministry of Health, 1987.Google Scholar
12Foy, H, Kondi, A. Hookworm in the etiology of tropical iron deficiency anemia. Trans. R. Soc. Trop. Med. Hyg. 1960; 54: 419–33.CrossRefGoogle Scholar
13World Health Organization. Iron Deficiency Anemia. Technical Report Series no. 182. Geneva: WHO, 1959.Google Scholar
14Layrisse, M, Roche, M. The relationship between anemia and hookworm infection. Am. J. Hyg. 1964; 79: 279–87.Google ScholarPubMed
15World Health Organization. Report of the WHO/UNICEF/UNU Consultation on Indicators and Strategies for Iron Deficiency and Anemia Programmes. Geneva: WHO, 1994.Google Scholar
16Gibson, RS. Principles of Nutritional Assessment. New York: Oxford University Press, 1990.Google Scholar
17United Nations. How to Weigh and Measure Children: Preliminary Version. New York: United Nations, 1986.Google Scholar
18Agren, G, Gibson, R. Food Composition for Use in Ethiopia I. Addis Abeba: Ethiopian Nutrition Institute, 1964–1975.Google Scholar
19World Health Organization. The Quantity and Quality of Breast Milk. Geneva: WHO, 1985.Google Scholar
20International Nutritional Anemia Consultative Group (INACG). Measurement of Iron Status. Washington DC: The International Nutritional Anemia Consultative Group, 1985.Google Scholar
21Powers, LW, Diagnostic Hematology: Clinical and Technical Principles. St Louis: Mosby, 1989.Google Scholar
22 Center for Disease Control (CDC). Epi Info version 5. Atlanta: CDC, 1994.Google Scholar
23 Stata Corporation. Stata version 3.1. Texas: Stata Corporation, 1991.Google Scholar
24Vaughan, VC, McKay, RJ, Behrman, RE, Nelson, WE. Nelson Textbook of Pediatrics. Philadelphia: WB Saunders Company, 1979: 1375–8.Google Scholar
25Health and Welfare Canada (HWC). Nutrition Recommendations: The Report of the Scientific Review Committee. Ottawa: HWC, 1990.Google Scholar
26Braunwald, E, Isselbacher, KJ, Petersdorf, RG, Wilson, JD, Martin, JB, Bauci, AS. Harrison's Principles of Internal Medicine. New York: McGraw-Hill Company, 1987: 1489–98.Google Scholar
27Adish, AA, Esrey, SA, Gyorkos, TW, Jean-Baptiste, J, Rojhani, A. Effect of consumption of food cooked in iron pots on iron status and growth of young chirldren: randomised trial. Lancet 1999; 353: 712–16.CrossRefGoogle ScholarPubMed
28Stephenson, L. Impact of Helminth Infection on Human Nutrition. London: Taylor & Francis, 1987.Google Scholar
29Mahiou, C, Frappaz, D, Freycon, MT, Freycon, F. Iron deficiency in infants and children (in French). Pediatrics 1992; 47: 551–5.Google Scholar
30Roodenburg, AJ. Iron supplementation during pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 1995; 61: 65–71.CrossRefGoogle ScholarPubMed
31Sharma, DC, Mathur, R. Correction of anemia and iron deficiency in vegetarians by administration of ascorbic acid. Ind. J. Physiol. Pharmacol. 1995; 39: 403–6.Google ScholarPubMed
32Mao, X, Yao, G. Effect of vitamin C supplementations on iron deficiency anemia in Chinese children. Biomed. Environ. Sci. 1992; 5: 125–9.Google ScholarPubMed
33Haghshenass, M, Mahloudij, M, Reinhold, JG, Mohammadi, N. Iron-deficiency in an Iranian population associated with high intakes of iron. Am. J. Clin. Nutr. 1972; 25: 1143–6.CrossRefGoogle Scholar
34Newall, CA, Anderson, LA, Phillipson, JD. Fenugreek: Herbal Medicines, A Guide for Health Care Professionals. London: Pharmaceutical Press, 1996, 117–18.Google Scholar
35Hamdaoui, M, Hedhili, A, Doghri, T, Tritar, B. Effect of tea on iron absorption from the typical Tunisian meal ‘couscous’ fed to healthy rats. Ann. Nutr. Metabol. 1994; 38: 226–31.CrossRefGoogle ScholarPubMed
36Lawless, JW, Latham, M, Stephenson, LS, Kinoti, SN, Perlet, AM. Iron supplementation improves appetite and growth in anemic Kenyan primary school children. J. Nutr. 1994; 124: 645–54.CrossRefGoogle ScholarPubMed
37Committee on Nutrition. Relationship between iron status and incidence of infection in infancy. Pediatrics 1978; 62: 246–50.CrossRefGoogle Scholar
38Pollitt, E. Functional significance of the covariance between protein energy malnutrition and iron deficiency anemia. J. Nutr. 1995; 125: S2272–77.CrossRefGoogle ScholarPubMed
39Burger, SE, Esrey, SA. Water and sanitation: health and nutrition benefits to children. In: Pinstrup-Anderson, P, Pelletier, D, Alderman, H, eds, Child Growth and Nutrition in Developing Countries: Priorities for Action. Ithaca: Cornell University Press, 1995: 153–75.Google Scholar
40Ahmed, F, Mohiduzzam, M, Barua, S, et al. Effect of family size and income on the biochemical indices of urban school children of Bangladesh. Eur. J. Clin. Nutr. 1992; 46: 465–73.Google ScholarPubMed