1. 1. IRON DEFICIENCY ANEMIA
2. 2. Introduction Iron is one of the most important elements in nutrition of fundamental importance in life Inadequate intake of iron leads to IDA IDA is a problem of serious PHS, given its IDA is a problem of serious PHS, given its importance on psychological and physical development, behavior and work performance. It is the most prevalent nutritional problem in the world today, affecting more than 800 million people.
3. 3. Functions: The body of an adult man contains 3-4gm of iron, of which >2/3 is present in hgb constituent of Hgb, myoglobin, the cytochromes, catalase, peroxidase, and certain other enzymescatalase, peroxidase, and certain other enzymes Important in oxygen transport Cellular respiration & tissue oxidation
4. 4. Physiology Takes place in the stomach and through out the small intestine; however, the greatest absorption occurs in the upper part of Small intestineintestine Only 10% of the iron present in cereals, vegs, and pulses is absorbed 30% from meat; 20% from soyabean; and 15% from fish
5. 5. Causes: The immediate causes are inadequate intake of iron and infection other conditions that lead to iron deficiency are depicted in figure 1.are depicted in figure 1. Infection is the commonest cause and congenital abnormalities (hemolytic diseases) do rarely cause public health importance
6. 6. REQUIREMENT Age Amount required 0-6 months 6-12 months 1-3 years 40mcg 50mcg 70mcg1-3 years 4-6 years 7-10 years 11+ years Pregnant Lactating 70mcg 90mcg 120mcg 150mcg 375mcg 200mcg 6
7. 7. Causes cont
8. 8. Consequences Infants and children Impaired motor development and coordination Impaired language development and scholastic achievement Psychological and behavioral effects, fatigue insecurity etc. Decreased physical activity Decreased physical activity In adults of both sexes Decreased physical work and earning capacity Decreased resistance to fatigue In pregnant women Increased maternal morbidity and mortality Increased fatal morbidity and mortality Increased risk of low birth weight
9. 9. Source: Animal: Liver Glandular Organs Meat, Sea Food Meat, Sea Food Plant: Enriched Cereals Dried Fruits(Peaches,apricot,prune,grapes,risins) Dark Green leafy vegetables
10. 10. Type of food iron: Heme: organic, efficiently absorbed Non-heme: inorganic. Less bioavailable
11. 11. Risk groups: Primary School children, and Women of reproductive age (pregnant & lactating)
12. 12. Determinates of Iron Absorption Dietary factor: Enhancers: Ascorbic acid, low ph, poultry and other sea food Inhibitors: Phytates, and poly phenols Inhibitors: Phytates, and poly phenols Host factor: Iron status Health status (infection, mal-absorption)
13. 13. MAGNITUDE OF THE PROBLEM (GLOBAL) ID is considerably more prevalent in the developing world and in the industrialized world (36% VS 3) Except for adult males, the estimated prevalence of anemia in all groups is more thanprevalence of anemia in all groups is more than 40% in both regions and is as high as 65% in pregnant women in South Asia in Latin America the prevalence of anemia is lower, ranging from 13% in adult males to 30% in pregnant women. In Asia prevalence ranges from 11% in adult males to 22% in school age
14. 14. Cont Young children and pregnant women are the most affected with an estimated prevalence of 43% and 51% respectively. Anemia prevalence among school age children is 37%, non pregnant women 35% and adultis 37%, non pregnant women 35% and adult males 18%.
15. 15. Affected 5% 2% 14% 1% 3% Africa America S.East Asia 3% 25% 50% S.East Asia Europe E.Mediterranean W. Pacific Total Population affected by IDA, WHO 1993Population affected by IDA, WHO 1993
16. 16. National status Nutritional anemia in Ethiopia has not yet been studied in the general population However experience from certain hospitals in the country indicated IDA to be prevailingthe country indicated IDA to be prevailing According to the assessment of IDA among pregnant and lactating mothers carried out in the rural parts of the nation, the following was reported;
17. 17. The national report Study Period Indicators (hgb & SF) 1999-nationwide Mean=18.4% among PLW 2000-work done in urban slum communities, AA (21.2%) among lactating2000-work done in urban slum communities, AA (21.2%) among lactating mothers 2005 survey-nationwide 18.1 2005 EDHS nationwide (anemia ) Women -30.4 based on hgb Children -54.0based on hgb
18. 18. Severity of IDA and their public health importance Low Hgb for age Severity of IDA Action suggested 40% Severe Intervene using medicinal tablets
19. 19. Methods of assessments - Clinical sign and symptoms of anemia - Biochemical
20. 20. Control and prevention of IDA Treatment of cases The treatment of IDA is technically quite simple, requiring only the administration of medicinal Iron. Prevention: Is somewhat more complexPrevention: Is somewhat more complex however; the simpler ones can be applied through primary health care Iron supplementation De-worming Dietary modification and fortification Nutrition education Control of direct causes such as malaria