An observational study of childhood iron deficiency anaemia and the factors affecting the outcome of oral iron therapy
DOI:
https://doi.org/10.18203/2349-3291.ijcp20232247Keywords:
IDA, Iron therapy, TeaAbstract
Background: Iron deficiency is the most common cause of anaemia worldwide. In-depth studies examining facilitators and barriers to oral iron therapy are lacking. The aim of our study is to determine the factors affecting the outcome of oral iron therapy in iron deficiency anaemia.
Methods: This is an observational study conducted in a tertiary hospital in Mumbai in children in the age group of 12 to 60 months. Out of a total of 416 children screened, 208 were eligible for oral iron therapy and were given oral iron in the dose of 3 milligrams per kilogram per day and reviewed after two months. A comprehensive questionnaire was given to parents after the completion of therapy to study the factors affecting iron therapy. The details were then analysed using Excel sheets, and correlation was calculated using SPSS program version 20.0.
Results: After 2 months of oral iron therapy, IDA was corrected in 68.98%. Factors that led to an unsatisfactory outcome with iron therapy were, history of low birth weight, past hospital admissions, gastrointestinal side effects, malnutrition, and children who had tea, milk, or food with iron therapy. In contrast, children who took iron on an empty stomach and along with vitamin C-rich foods had a significant increase in haemoglobin levels.
Conclusions: Various modifiable factors affect adherence and outcome of oral iron therapy. Tea and Coffee are to be avoided when the child is on iron therapy. Meticulous counselling of parents and children is pivotal for the successful management of IDA with oral iron therapy.
Metrics
References
McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr. 2009;12(4):444-54.
National Family Health Survey (NFHS-5), 2019-21: India. Available at: https://main.mohfw.gov.in/sites/ default/files/NFHS-5_Phase-II_0.pdf. Accessed on 20 November 2022.
Zijp IM, Korver O, Tijburg LB. Effect of tea and other dietary factors on iron absorption. Crit Rev Food Sci Nutr. 2000;40(5):371-98.
Santokh I, Gaur B, Narayan R, Maini B, Bharadwaj A. Iron deficiency anemia among hospitalized children in a rural teaching hospital: a cross sectional study. Int J Contemp Pediatr. 2018;5(4):1631.
Pietrzak-Fiećko R, Kamelska-Sadowska AM. The comparison of nutritional value of human milk with other mammals’ milk. Nutrients. 2020;12(5):1404.
Levy-Costa RB, Monteiro CA. Cow's milk consumption and childhood anemia in the city of São Paulo, southern Brazil. Revista Saude Public. 2004;38: 797-803.
Ziegler EE. Consumption of cow's milk as a cause of iron deficiency in infants and toddlers. Nutrition reviews. 2011;69(1):S37-42.
Powers JM, Daniel CL, McCavit TL, Buchanan GR. Deficiencies in the management of iron deficiency anemia during childhood. Pediatr Blood Cancer. 2016; 63(4):743-5.
Lisbôa MB, Oliveira EO, Lamounier JA, Silva CA, Freitas RN. Prevalence of iron deficiency anemia in children aged less than 60 months: A population-based study from the state of Minas Gerais, Brazil. Revista Nutr. 2015;28:121-31.
Vieira AC, Diniz AS, Cabral PC, Oliveira RS, Lóla MM, Silva SM, et al. Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers. J Pediatr. 2007;83:370-6.
Habib MA, Black K, Soofi SB, Hussain I, Bhatti Z, Bhutta ZA, Raynes-Greenow C. 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. PloS one. 2016;11(5):e0155051.
Borgna-Pignatti C, Zanella S. Pica as a manifestation of iron deficiency. Exper Rev Hematol. 2016;9(11): 1075-80.
Zainel AJ, Osman SR, Al-Kohji SM, Selim NA. Iron deficiency, its epidemiological features and feeding practices among infants aged 12 months in Qatar: a cross-sectional study. BMJ. 2018;8(5):e020271.
Thompson A. Low birth weight and anemia randomized control trial, Middleton, USA. Indian Pediatr J. 2002;52(5):23240.
Auerbach M, Behm BW, Sankineni A. Treatment of iron deficiency in gastroenterology: a new paradigm. Pract Gastroenterol. 2020.
Rockey DC. Treatment of iron deficiency. Gastroenterol. 2006;130(4):1367-8.
Smith NJ, Schulz J. The absorption of iron in infants and children, Iron in clinical medicine. Univ California J. 1958;2:95.
Hallberg L, Brune M, Rossander L. The role of vitamin C in iron absorption. Int J Vitam Nutr Res Suppl. 1989; 30:103-8.