ความชุกของภาวะโลหิตจางและประสิทธิผลของการป้องกันโลหิตจางในทารกอายุ 9 - 12 เดือน ที่มารับบริการในคลินิกเด็กสุขภาพดี โรงพยาบาลตำรวจ

Yodkwan Aphikulchatkit

Authors

Yodkwan Aphikulchatkit Police General Hospital

Keywords:

anemia, iron deficiency anemia, infant aged 9-12 months

Abstract

Anemia in infants and preschool children is a permanent public health problem of Thailand. The most common causes of anemia are iron deficiency and Thalassemia. The purposes of this retrospective descriptive study were to find out the prevalence and causes of anemia among infants aged 9-12 months who had hematocrit (Hct) screening for anemia in well baby clinic, Police General hospital. Data were extracted from medical records between 1 Oct 2017 to 30 Sep 2018. Also, They were to evaluate effectiveness of supplementation weekly 12.5 mg. oral elemental iron compared with control on prevalence of iron deficiency anemia (IDA) in infants. Anemic infants were followed up in changing of Hct after treatment of iron deficiency anemia. Baseline characteristics of samples were analyzed by using descriptive statistic. The chi-square statistic was used for comparing between two independent groups. Limit for statistical significance was set at .05.

Results showed that 129 out of 550 infants were anemia (23.45 percent). While the cut point of anemic Hct is less than 33%. There were 117 infants to find the causes and follow up. Predominant causes of anemia were iron deficiency and abnormal types of hemoglobin. 62 Infants had iron deficiency anemia (52.99 percent). Infants with IDA were proofed by monitoring the response in increase of 3% in Hct after taking 3 mg/kg/day oral elemental iron for 1-2 months.

There was no statistically significant difference in prevalence of IDA between weekly iron supplemented group and control group (35.29 and 60 % , p = .132) .All infants with IDA were responded to treatment by Hct was increased 4.44±1.42% (M± SD).The results lead to conclude that we should focus on not only awareness of anemia and IDA among infants but also prevention of iron deficiency anemia. The Increase dosage of weekly elemental iron supplementation may be effective in prevention of IDA and reduction in prevalence of IDA. We should recommend earlier about appropriate complementary food for infants that have risk factors of iron deficiency.

Downloads

Download data is not yet available.

References

Autthawee, B., & Phongphetdit, B. (2020). Control and prevention of iron deficiency anemia in children aged 6-12 months. Nursing Journal of The Ministry of Public Health, 30(1), 82-93.

Bernard, R. (2000). Fundamentals of biostatistics (5th ed.). Duxbury: Thomson learning.

Health intervention and technology assessment program. (2014). Prevention of anemia in children. Retrieved from http://www.hitap.net/wp-content/uploads/2014/12/Draft-QS-Anemia_final.pdf

Kohli-Kumar, M. (2001). Screening for anemia in children: AAP recommendations-A critique. Pediatrics, 108, e56.

Leelapiromchai, P. (2013). Effectiveness of daily and weekly iron supplementation in the prevention of anemia in toddler (Thesis, the Diploma of Thai Board of Pediatrics of The Medical Council). Department of pediatrics, Faculty of medicine, Chulalongkorn University, Bangkok, Pathum Wan.

Matos, T. A., Arcanjo, F. P., Santos, P. R., & Arcanjo, C. C. (2016). Prevention and treatment of anemia in infants through supplementation, assessing the effectiveness of using iron once or twice weekly. Journal of tropical pediatrics, 62(2), 123-130.

Ministry of Public Health, Bureau of Nutrition. (2013).Manual of preventing and controlling iron deficiency anemia. Nonthaburi: no publisher.

Ministry of Public Health. Department of medical service. (2017). Guidelines for the care of thalassemia patients in general practice. Bangkok: The War veterans affairs office printing.

Mongkhonporn, V. (2013). Situation and results of treatment for anemia in well child health clinic-hospital. Journal Regional Health Promotion Center 5 Nakhon Ratchasima, 1,18-35.

Arcanjo, F. P. N., Arcanjo, C. P. C., Megalhaes, S. M., Leite, A. J. M. (2013). Daily and weekly iron supplementations are effective in increasing hemoglobin and reducing anemia in infants. Journal of tropical Pediatrics, 59(3), 175-179.

Nuchprayoon, I. (2003). Iron-deficiency anemia. In R. Samransamruajkit, Ch. Pancharoen, U. Tissayakorn (Eds.), Pediatrics: Gold standard of clinical practice (pp.353-363). Bangkok: Chulalongkorn University Printing House.

Raksasin, S. (2017). Iron deficiency anemia and related factors among infants aged9-12months In WellBaby Clinics of Panthong Hospital. Thai journal of pediatrics, 56(4), 319-327.

Rojroongwasinkul, N., Kijboonchoo, K., Wimonpeerapattana, W., Purttiponthanee, S., Yamborisut, U., Boonpraderm, A., . . . Khouw, I. (2013). SEANUT: The nutritional status and dietary intakes of 0.5–12-year-old Thai children. British Journal of Nutrition, 110, S36–S44.

Sukkayanudit, N. (2018). Prevalence and risk factors for iron deficiency anemia among children aged 6-12 months Thatoom hospital, Surin Province. Ubon Medical Journal, 1(1), 10-20.

Tantracheewathorn, S., & Lohajaroensub, S. (2005). Incidence and risk factors of iron deficiency anemia in term infants. Journal of the Medical Association of Thailand, 88(1), 45-51.

The Royal college of Pediatricians of Thailand & Pediatric Society of Thailand. (2014). Guideline in child health supervision. Bangkok: Sappasan company.

World Health Organization (WHO). (2001). Iron deficiency anemia: Assessment, prevention and control A guide for programme managers. WHO/NIID (Report no 013).

World Health Organization (WHO). (2015). The global prevalence of anaemia in 2011. Retrieved from https://www.who.int/nutrition/publications/micronutrients/global_prevalence_anaemia_2011/en/

World Health Organization (WHO). (2020). Prevalence of anaemia in children under 5 years. Retrieved from https://www.who.int/data/gho/data/indicator-details/GHO/prevalence-of-anaemia-in-children-under-5-years-(-)

Yurdakok, K., Temiz, F., Yalcin, S. S., & Gumruk, F. (2004). Efficacy of daily and weekly iron supplementation on iron status in exclusively breast-fed infants. Journal of Pediatric hematology/oncology, 26(5), 284-288.