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Nutritional anaemia
Nutritional anaemia:Who definition: a condition in which the Hb content of the
blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency. Iron deficiency is the most frequent cause,
less frequently folate or vit.B12
Population affected Women of child bearing age Young children During pregnancy and lactation
Global Prevalence of Anaemia:Pregnant Women
0
10
20
30
40
50
60
70
80A
fric
a
Am
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cas
So
uth
-Ea
stA
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Eu
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Ea
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Source: WHO (1999)
Global Prevalence of Anaemia:Preschool Children
0
10
20
30
40
50
60
70A
fric
a
Am
eri
cas
So
uth
-Ea
stA
sia
Eu
rop
e
Ea
ste
rnM
ed
iterr
an
ea
n
We
ste
rnP
aci
fic
Source: WHO (1999)
Proposed New Goal:
Reduce by one third the prevalence of anaemia, including iron deficiency, by 2010; and
Main Factors Contributing to Anaemia
Iron deficiency Poor bioavailability of consumed iron Insufficient dietary iron intake
Chronic and recurrent infections that interfere with food intake and absorption/utilization of iron Helminth infections, primarily Hookworm Chronic diarrheal disease HIV Malaria
Iron Deficiency Anaemia
Global situation. Most common nutritional disorder in the world Lowers resistance to disease and weakens a child's
learning ability and physical stamina Significant cause of maternal mortality, increasing the risk
of hemorrhage and infection during childbirth. Nearly 2 billion people estimated to be anemic and
millions more are iron deficient, the vast majority are women.
Causes of iron deficiency anaemia.
Inadequate intake Poor bioavailability of dietary iron Excessive loss . Increased demands
Detrimental effects.
Pregnancy Infection work capacity
Iron: In human body. Functions. Sources. Absorption. (Conservation) Iron losses.
Requirements of iron:
Age groupDaily iron needed in mg
Infants(5-12 m)0.7
Children (1-12 y)1.0
Adolescent(13-16 y)1.8 males
2.4 females.
Adults ,males0.9
Age group
Adult females
Daily iron needed in mg
Menstruation2.8
Pregnancy(1st half)0.8
(2nd half)3.5
lactation2.4
Post-menopause0.7
Requirements of iron:
Stages of iron deficiency: Decreased storage. Latent iron deficiency. Overt iron deficiency.
Diagnosis of anaemia:
Cut-off points for the diagnosis of anaemiag/dl (venous)MCHC
Adult males1334%
Adult females, non -pregnant1234%
Adult females, pregnant1134%
Children,6m-6years1134%
Children 6 to 14 years1234%
Evaluation of iron status: Heamoglobin concentration. Serum iron concentration( less than .5mg/dl) Serum ferritin.(less than 10mcg/l) Serum transferrin saturation (less than 16%)
Interventions to Control Anaemia
Depends on etiology For iron deficiency: supplementation and fortification For parasitic disease control: appropriate measures for
prevention and presumptive treatment
Prevention and control: Iron supplementation Iron fortification Other strategies:
-changing dietary habits.
- control of parasites.
- nutrition education. Treatment of severe anaemia.
Regular dietary intake of iron and folic rich foods for high risk groups.
Health education to mothers attending antenatal and immunization clinics.
Incorporation of iron rich food in weaning foods. Promotion of vit. C consumption. Promotion of growing iron rich foods in home gardens. Reduce consumption of tea especially for pregnants.
Promoting consumption of iron-rich foods
Promoting consumption of iron and folic acid supplements:
All pregnant women. Check use of supplements during
immunization sessions. For monitoring distribution as well as
consumption use mother and infant immunization cards.
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