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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-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

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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.