Prevalence of anemia and iron deficiency anemia in Chinese ...
11. Community Based Screening and Management of Adolescent Anemia in Tribal Areas of India Key to...
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10. ORTHOSTATIC TOLERANCE TESTING IN A PROSPECTIVE COHORT OF ADOLESCENTS WITH CHRONIC FATIGUE SYNDROME AND RECOVERED CONTROLS FOLLOWING INFECTIOUS MONONUCLEOSIS Ben Katz 1 , Julian Stewart, MD, PhD 3 , Yukiko Shiraishi, PhD 4 , Cynthia Mears, Associate Professor 1 , Cynthia Mears, DO 2 , Renee Taylor, MA, PhD 5 . 1 Feinberg School of Medicine and Children’s Memorial Hospital 2 Feinberg School of Medicine, Northwestern University and Children’s Memorial Hospital 3 New York Medical College 4 Private Practice 5 University of Illinois at Chicago Purpose: To measure standing orthostatic tolerance in adoles- cents with CFS and controls 6 months following IM Methods: Thirty-six adolescents diagnosed with CFS 6 months following IM and 45 recovered controls completed question- naires regarding autonomic symptoms and had standing or- thostatic tolerance testing (SOTT) performed. The 2 analysis and Spearman correlations were used to correlate the results of SOTT and the diagnosis of CFS. Pearson and Spearman cor- relations were performed to study the relationships between SOTT, the diagnosis of CFS, and the number of autonomic symptoms present. Results: Adolescents diagnosed with CFS and recovered con- trols did not differ significantly in age, weight, or body-mass index. There was a correlation between autonomic symptoms, standing orthostatic intolerance and the diagnosis of CFS at 6 months. There was also a correlation between autonomic symptoms at baseline and the diagnosis of CFS at 6 months. Conclusions: Adolescents who meet the criteria for CFS 6 months following IM have, as a group, more standing ortho- static intolerance, and autonomic symptoms than recovered controls. Those who were more tired at baseline also had more autonomic symptoms 6 months following mononucleosis. Whether these abnormal findings are a cause or effect of CFS or whether they can be used to determine objectively which adolescents following IM will develop CFS remains to be de- termined. However, this study uniquely and prospectively demonstrates that IM produces both fatigue and associated orthostatic intolerance in a subset of patients. Sources of Support: R01HD4330101A1 from the National In- stitute of Child Health and Human Development. 11. COMMUNITY BASED SCREENING AND MANAGEMENT OF ADOLESCENT ANEMIA IN TRIBAL AREAS OF INDIA KEY TO REDUCTION IN MATERNAL MORTALITY Archana Joshi, Post Graduation in Foods and Nutrition. Deepak Foundation Purpose: Prevention of anemia amongst adolescent girls has a great potential in reducing the risk of maternal death. More than half of young adolescents in Gujarat State of India, are anemic and its prevalence is considerably higher among those in (74%). While many school and clinic based interventions have shown promising results, albeit with poor scalability and replicability, community based interventions within the exist- ing government delivery system are scarce. Methods: Deepak Foundation, a voluntary agency initiated screening of young mothers for anemia to promote compli- ance for consumption of iron and folic acid (IFA) supplement and referral of severely anemic mothers at tertiary care facili- ties. The Foundation is implementing anemia control program (ACP) as part of a larger intervention Safe Motherhood and Child Survival project covering 700,000 tribal populations in the district in partnership with the Government of Gujarat. The ACP leverages on monthly nutrition and health days (NHD) campaigns held in all village jointly by the Department of Health and Family Welfare and Women and Child Develop- ment to provide preventive, promotive, and curative health and nutrition services to women and children. The joint initia- tive is conducted with active involvement of village based committees Apart from conducting blood and urine test, infor- mation on prevention and control of anemia by demonstration of recipes made locally available, culturally acceptable, iron rich ingredients, distribution of IFA and deworming tablets, and identification of severely anemic girls, their counseling and referral to equipped health centers are also facilitated through the campaign based approach of the intervention. Each beneficiary is provided with a color-coded card specify- ing the blood group, Hb and glucose level to motivate him or her to comply with appropriate treatment. Results: A total of 322 campaigns were conducted during a period of 7 months (i.e., January-July 2010) in which 1810 ado- lescent girls were covered. Screening for anemia showed that nearly 95.3% of these girls were anemic (Hb 12 g/dL), 53.6 % were moderately anemic (Hb 7-9.9 g/dL) and 2.2 % were severely anemic (Hb 7 g/dL). IFA tablets through the Government’s stock were distributed to 81.7% girls and deworming to 4% girls. A total of 42.5% of severely anemic girls were able to access appropriate treatment (double IFA supplements, blood transfusion, intra-ve- nous injectable iron) at equipped health facilities. As early mar- riage (before 18 years) is common in these areas, as many as 9.6% of these adolescent girls were pregnant and 12.3% were nursing, indicating much higher iron requirements over and above that required for their own growth. Conclusions: The prevalence of anemia was disproportionately high among tribal women due to poverty, inadequate diet, prev- alence of sickle cell anemia, tapeworm infestation, malaria, phys- iological conditions pregnancy and lactation, and poor access to health services. Factors such as timely screening of young women for anemia, compliance to intake of iron supplements and the correct estimates on prevalence of the problem are im- perative to design appropriate and intensive intervention strat- egy for curtailing anemia among young women who die need- lessly during pregnancy and postpartum period in tribal areas. Sources of Support: Deepak Group of Companies (website: www.deepakfoundation.org). 12. SOURCES OF FOLATE, VITAMIN D, AND CALCIUM IN URBAN ADOLESCENT FEMALES Evan Howe, PhD, MPH 1 , Andrea Bonny, MD 2 . 1 Case Western Reserve University 2 MetroHealth Medical Center S23 Poster Abstracts / 48 (2011) S18 –S120
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Transcript of 11. Community Based Screening and Management of Adolescent Anemia in Tribal Areas of India Key to...
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S23Poster Abstracts / 48 (2011) S18–S120
10.
ORTHOSTATIC TOLERANCE TESTING IN A PROSPECTIVECOHORT OF ADOLESCENTS WITH CHRONIC FATIGUESYNDROME AND RECOVERED CONTROLS FOLLOWINGINFECTIOUS MONONUCLEOSISBen Katz1, Julian Stewart, MD, PhD3, Yukikohiraishi, PhD4, Cynthia Mears, AssociateProfessor1, Cynthia Mears, DO2, Renee Taylor,A, PhD5. 1Feinberg School of Medicine andhildren’s Memorial Hospital 2Feinberg School
of Medicine, Northwestern University andChildren’s Memorial Hospital 3New YorkMedical College 4Private Practice 5University ofllinois at Chicago
Purpose: Tomeasure standing orthostatic tolerance in adoles-cents with CFS and controls 6 months following IMMethods: Thirty-six adolescents diagnosedwith CFS 6monthsfollowing IM and 45 recovered controls completed question-naires regarding autonomic symptoms and had standing or-thostatic tolerance testing (SOTT) performed. The �2 analysisand Spearman correlations were used to correlate the resultsof SOTT and the diagnosis of CFS. Pearson and Spearman cor-relations were performed to study the relationships betweenSOTT, the diagnosis of CFS, and the number of autonomicsymptoms present.Results: Adolescents diagnosed with CFS and recovered con-trols did not differ significantly in age, weight, or body-massindex. Therewas a correlation between autonomic symptoms,standing orthostatic intolerance and the diagnosis of CFS at 6months. There was also a correlation between autonomicsymptoms at baseline and the diagnosis of CFS at 6 months.Conclusions: Adolescents who meet the criteria for CFS 6months following IM have, as a group, more standing ortho-static intolerance, and autonomic symptoms than recoveredcontrols. Thosewhoweremore tired at baseline also hadmoreautonomic symptoms 6 months following mononucleosis.Whether these abnormal findings are a cause or effect of CFS orwhether they can be used to determine objectively whichadolescents following IM will develop CFS remains to be de-termined. However, this study uniquely and prospectivelydemonstrates that IM produces both fatigue and associatedorthostatic intolerance in a subset of patients.Sources of Support: R01HD4330101A1 from the National In-stitute of Child Health and Human Development.
11.
COMMUNITY BASED SCREENING AND MANAGEMENT OFADOLESCENT ANEMIA IN TRIBAL AREAS OF INDIA KEY TOREDUCTION IN MATERNAL MORTALITYArchana Joshi, Post Graduation in Foods andNutrition. Deepak Foundation
Purpose: Prevention of anemia amongst adolescent girls has areat potential in reducing the risk of maternal death. Morehan half of young adolescents in Gujarat State of India, arenemic and its prevalence is considerably higher among thosen (74%). While many school and clinic based interventions
ave shown promising results, albeit with poor scalability andeplicability, community based interventionswithin the exist-ng government delivery system are scarce.ethods: Deepak Foundation, a voluntary agency initiatedcreening of young mothers for anemia to promote compli-nce for consumption of iron and folic acid (IFA) supplementnd referral of severely anemic mothers at tertiary care facili-ies. The Foundation is implementing anemia control programACP) as part of a larger intervention Safe Motherhood andhild Survival project covering 700,000 tribal populations inhe district in partnership with the Government of Gujarat.he ACP leverages on monthly nutrition and health daysNHD) campaigns held in all village jointly by the Departmentf Health and Family Welfare andWomen and Child Develop-ent to provide preventive, promotive, and curative healthnd nutrition services towomen and children. The joint initia-ive is conducted with active involvement of village basedommittees Apart from conducting blood and urine test, infor-ation on prevention and control of anemia by demonstrationf recipes made locally available, culturally acceptable, ironich ingredients, distribution of IFA and deworming tablets,nd identification of severely anemic girls, their counselingnd referral to equipped health centers are also facilitatedhrough the campaign based approach of the intervention.ach beneficiary is provided with a color-coded card specify-ng the blood group, Hb and glucose level to motivate him orer to comply with appropriate treatment.esults: A total of 322 campaigns were conducted during aeriod of 7 months (i.e., January-July 2010) in which 1810 ado-escent girls were covered. Screening for anemia showed thatearly 95.3% of these girls were anemic (Hb �12 g/dL), 53.6 %eremoderately anemic (Hb7-9.9 g/dL) and2.2 %were severelynemic (Hb�7g/dL). IFA tablets through theGovernment’s stockere distributed to 81.7% girls anddeworming to 4% girls. A totalf 42.5% of severely anemic girls were able to access appropriatereatment (double IFA supplements, blood transfusion, intra-ve-ous injectable iron) at equipped health facilities. As early mar-iage (before 18 years) is common in these areas, asmany as 9.6%f these adolescent girls were pregnant and 12.3%were nursing,ndicating much higher iron requirements over and above thatequired for their own growth.onclusions: The prevalence of anemia was disproportionatelyigh among tribal women due to poverty, inadequate diet, prev-lenceof sickle cell anemia, tapeworminfestation,malaria, phys-ological conditions pregnancy and lactation, and poor access toealth services. Factors such as timely screening of youngomen for anemia, compliance to intake of iron supplementsnd the correct estimates on prevalence of the problem are im-erative to design appropriate and intensive intervention strat-gy for curtailing anemia among young women who die need-essly during pregnancy and postpartum period in tribal areas.ources of Support: Deepak Group of Companies (website:ww.deepakfoundation.org).
12.
SOURCES OF FOLATE, VITAMIN D, AND CALCIUM IN URBANADOLESCENT FEMALESEvan Howe, PhD, MPH1, Andrea Bonny, MD2.1Case Western Reserve University 2MetroHealthedical Center
