Prevalence of anemia and outcome of presumptive iron supplement therapy in children age of 9 - 12 months in Health Promotion Center 7 Khon Kaen

Abstract

Anemia is a common nutritional problem in pediatric and important problem
in public health. Anemia in children age 9-12 months affect development, intelligence
level and learning ability. Therefore, screening for iron defciency anemia, protection
against iron defciency anemia and providing early treatment are crucial for body growth
and brain development. This study aimed to evaluate the prevalence of anemia in
apparently healthy children age of 9 – 12 months and outcome of presumptive iron
supplement therapy.
All children visited in well-baby clinic, Health Promoting Center 7, Khon Kaen,
Thailand since July 1st 2019 to December 31th 2020 were included in the study.
The medical records were reviewed. Categorical data were presented as percentages
and continuous data were presented in mean or median. Bivariate and multivariable
analysis were performed with logistic regression model. The adjusted odds ratio (aOR)
with its 95%CI and p-value were obtained. Statistical analyses were performed by
using STATA version 14 (Stata Corp, College Station, TX, United States)
Total of 898 children were visited well-child clinic and screening for anemia
was performed, of those, 360 (40.1%, 95%CI 36.9 – 43.3) had Hb less than 11 mg/dl.
Anemic children have mean Hb 10.3 g/dl, 56.7% were male and 43.3% were female.
86.1% had normal body weight, 9.4% and 4.4% were underweight and overweight,
respectively. 73.6% had breast milk, 19.7% had infant formula and 6.7% had both
breast milk and infant formula. All children diagnosed anemia were treated with
presumptive iron supplementation 4-6 mg/kg/day. 138 (38.3%) Hb were increases
≥ 1 g/dl in frst or second follow up visit, defned as successful treatment. Factors
signifcantly affecting successful treatment were male (aOR 2.42, 95%CI 1.36-4.33, p-value=0.003), frst visit Hb 9.5-10.5 g/dl (aOR 2.39, 95%CI 1.13-5.05, p-value = 0.022),
frst visit Hb < 9.5 g/dl (aOR 18.23, 95%CI 3.82-86.83, p-value < 0.001) and patient’s
compliance (aOR 7.79, 95%CI 3.93-15.44, p-value < 0.01).
Anemia in children still had high prevalence and iron defciency was the major
cause. Less than half of anemic children were success in presumptive iron supplement
strategy. Boy and Hb less than 10.5 g/dl were more likely to success in treatment.
To improve outcome of treatment, care should be focus on improvement of patient’s
compliance and early investigate other causes of anemia in non-responder.