Duration of exclusive breastfeeding is a positive predictor of iron status in 6‐ to 10‐month‐old infants in rural Kenya

The prevalence of iron‐deficiency anemia (IDA) is high in infants in Sub‐Saharan Africa. Exclusive breastfeeding of infants to 6 months of age is recommended by the World Health Organization, but breast milk is low in iron. Some studies suggest exclusive breastfeeding, although beneficial for the infant, may increase risk for IDA in resource‐limited settings. The objective of this study was to determine if duration of exclusive breastfeeding is associated with anemia and iron deficiency in rural Kenyan infants. This was a cross‐sectional study of 6–10‐month‐old infants (n = 134) in southern coastal Kenya. Anthropometrics, hemoglobin (Hb), plasma ferritin (PF), soluble transferrin receptor (sTfR), and C‐reactive protein were measured. Body iron stores were calculated from the sTfR/PF ratio. Socioeconomic factors, duration of exclusive breastfeeding, nature of complementary diet, and demographic characteristics were determined using a questionnaire. Mean ± SD age of the infants was 7.7 ± 0.8 months. Prevalence of anemia, ID, and IDA were 74.6%, 82.1%, and 64.9%, respectively. Months of exclusive breastfeeding correlated positively with Hb (r = 0.187; p < .05) and negatively with sTfR (r = ?0.246; p < .05). sTfR concentrations were lower in infants exclusively breastfed at least 6 months compared with those exclusively breastfed for less than 6 months (7.6 (6.3, 9) vs. 8.9 (6.7, 13.4); p < .05). Controlling for gender, birth weight, and inflammation, months spent exclusively breastfeeding was a significant negative predictor of sTfR and a positive predictor of Hb (p < .05). The IDA prevalence in rural Kenyan infants is high, and greater duration of exclusive breastfeeding predicts better iron status and higher Hb in this age group.     

汉中市儿童、孕妇铁缺乏症流行病学调查研究分析

目的调查了解儿童、妇女铁减少(ID)、缺铁性贫血(IDA)及铁缺乏症(IDD)患病率。方法随机抽取汉中市城区7月～7岁儿童532名,30岁以下妊娠38周以内孕妇203名,30岁以下未孕育龄妇女200名为调查对象。检测了血红蛋白(Hb)、锌原卟啉(ZPP)、血清铁蛋白(SF)等指标。结果7个月～7岁儿童ID平均43.80%,IDA平均9.96%。其中7个月～12个月婴儿ID71.67%,IDA22.50%;3个月～36个月幼儿ID33.13%,IDA8.13%;37个月～7岁儿童ID37.30%,IDA5.16%。孕妇ID平均82.17%,IDA平均37.93%。其中早孕组ID75.91%,IDA14.46%,中孕组ID77.14%,IDA51.43%;晚孕组ID100.00%,IDA58.00%。未孕育龄妇女ID49.50%,IDA25.00%。儿童ID、IDA不同年龄组有显著差异(P<0.01),即年龄越小、患病率越高。孕妇孕龄组之间有显著性差异(P<0.01)。即孕龄越大,患病率越高。孕妇ID、IDA患病率与育龄妇女有显著性差异(P<0.01)。孕妇患病率明显高于育龄妇女。不同年龄组儿童、不同孕期孕妇及育龄妇女ID患病率均大于IDA患病率。结论本市儿童、孕妇、育龄妇女铁缺乏症比较普遍,ID、IDA患病率均高于国外和全国平均水平。隐性缺铁十分严重,已成为营养性铁缺乏症的主要问题。婴幼儿和晚期孕妇是铁缺乏症高发人群。     

Red Blood Cell Distribution Width and the Platelet Count in Iron-deficient Children Aged 0.5–3 Years

Early detection of iron deficiency (ID) and iron deficiency anemia (IDA) in young children is important to prevent impaired neurodevelopment. Unfortunately, many biomarkers of ID are influenced by infection, thus limiting their usefulness. The aim of this study was to investigate the value of red blood cell distribution width (RDW) and the platelet count for detecting ID(A) among otherwise healthy children. A multicenter prospective observational study was conducted in the Netherlands to investigate the prevalence of ID(A) in 400 healthy children aged 0.5–3 years. ID was defined as serum ferritin (SF) <12 μg/L in the absence of infection (C-reactive protein [CRP] <5 mg/L) and IDA as hemoglobin <110 g/L combined with ID. RDW (%) and the platelet count were determined in the complete blood cell count. RDW was inversely correlated with SF and not associated with CRP. Calculated cutoff values for RDW to detect ID and IDA gave a relatively low sensitivity (53.1% and 57.1%, respectively) and specificity (64.7% and 69.9%, respectively). Anemic children with a RDW >14.3% had a 2.7 higher odds (95% confidence interval [CI]: 1.2–6.3) to be iron deficient, compared with anemic children with a RDW <14.3%. The platelet count showed a large range in both ID and non-ID children. In conclusion, RDW can be helpful for identifying ID as the cause of anemia in 0.5- to 3-year-old children, but not as primary biomarker of ID(A). RDW values are not influenced by the presence of infection. There appears to be no role for the platelet count in diagnosing ID(A) in this group of children.     

Novel mutation in the TMPRSS6 gene with iron‐refractory iron deficiency anemia

Iron‐refractory iron deficiency anemia (IRIDA) is a rare autosomal recessive disease characterized by congenital hypochromic microcytic anemia, low transferrin saturation, low serum iron, normal–high serum ferritin, and increased hepcidin. This disease is caused by loss‐of‐function mutations in TMPRSS6 that lead to high hepcidin and result in severe anemia. We report our experience with an 11‐year‐old Japanese girl with hypochromic microcytic anemia, low serum iron, and high serum ferritin, with anemia that was refractory to the oral iron that was prescribed frequently from early childhood. Presence of high hepcidin suggested a diagnosis of IRIDA, which was eventually confirmed by identification of a novel homozygous mutation, p.Pro354Leu, in the TMPRSS6 gene. This case suggests that serum hepcidin should be routinely measured for differential diagnosis when patients with IDA are unresponsive to oral iron or have unusual clinical features.     

Iron Deficiency in Infants and Toddlers in the United States

Iron deficiency anemia (IDA) continues to be overwhelmingly the leading cause of anemia in early childhood and a global public health challenge. Although there has been a significant decrease in the frequency of IDA and iron deficiency (ID) in infants and toddlers in recent years in the United States, ID and IDA persist and the adverse effects of ID are long-lasting if not permanent. Moreover, ID can result in lead toxicity, and this toxic exposure, even with low levels, can impair neurocognitive function as well. This review describes the major steps that have taken place to decrease the frequency of ID and IDA.     

Changes in growth,anaemia, and iron deficiency among children aged 6–23 months in two districts in Nepal that were part of the post‐pilot scale‐up of an integrated infant and young child feeding and micronutrient powder intervention

There is limited research on integrated infant and young child feeding (IYCF) and micronutrient powders (MNPs) programmes operating at scale, despite widespread implementation. This study uses cross‐sectional baseline (n = 2,542) and endline (n = 2,578) surveys representative of children 6–23 months in two districts in Nepal that were part of a post‐pilot scale‐up of a IYCF–MNP programme. Multivariable log‐binomial regression models were used to estimate prevalence ratios (PRs) for stunting (length‐for‐age z‐score <?2), wasting (weight‐for‐length z‐score <?2), underweight (weight‐for‐age z‐score <?2), anaemia (altitude‐adjusted haemoglobin <110 μg/L), moderate or severe anaemia (altitude‐adjusted haemoglobin <100 g/L), iron deficiency (inflammation‐adjusted ferritin <12 μg/L), and iron deficiency anaemia (iron deficiency + anaemia [IDA]) at endline versus baseline and also to compare children in the endline survey based on frequency of mothers' interactions with female community health volunteers (FCHVs; >1× per month or monthly vs. <1× per month) and MNP coverage (1 or ≥2 distributions vs. none among children 12–23 months). Endline children were significantly less likely to be stunted than baseline children in both districts (multivariable‐adjusted PR [95% CI]: 0.77 [0.69, 0.85], P < 0.001 and 0.82 [0.75, 0.91], P < 0.001 in Kapilvastu and Achham, respectively); however, only Achham had significantly lower prevalences of underweight, moderate/severe anaemia, iron deficiency, and IDA at endline. At endline, 53.5% and 71.4% of children had tried MNP in Kapilvastu and Achham districts, respectively, consuming an average of 24 sachets from the last distribution. Frequent maternal–FCHV interactions were associated with a reduced risk of stunting and underweight at endline, whereas repeat MNP coverage was associated with reduced risk of anaemia and IDA. Future research using experimental designs should verify the potential of integrated IYCF–MNP programmes to improve children's nutritional status.     

Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia

Objective  To study the utility of red cell distribution width (RDW) in the diagnosis of iron deficiency among children with microcytic hypochromic anemia. Methods  151 children (6 months-12 years) with microcytic (MCV<75 fl) anemia were classified into iron deficient (IDA) and non-iron deficient anemia (non-IDA) on the basis of serum ferritin and total iron binding capacity (TIBC). RDW values were obtained on an automated hematology analyzer. Receiver operator curves (ROC) were constructed and the utility of RDW in diagnosis of iron deficiency was studied. Results  The mean RDW value was 18.37±2.22% in IDA group (97 children) compared to 16.55±1.51 % in the non-IDA group (54 children) (p<0.0001, unpaired t test). In IDA group, the mean RDW value was 16.60±1.78%, 17.95±1.91% and 20.55±1.32% among mild, moderate and severely anemic children (p<0.0001, ANOVA test). The corresponding values in non-IDA group were 16.03±1.25%, 16.76±1.20% and 16.77±2.68% respectively (p=0.269, ANOVA test). At a cut-off value of 17.4%, as obtained from the ROC curve, the sensitivity and specificity of RDW in diagnosis of IDA were 81.0% and 53.4% and a positive and negative predictive value of 63.0% and 72.2% respectively. Conclusion  RDW has a limited specificity for diagnosis of IDA among children with microcytic hypochromic anemia.     

Iron deficiency and cyanotic breath-holding spells: The effectiveness of iron therapy

Abstract

Aim: Frequent cyanotic breath holding spells cause fear and severe anxiety to parents. This study aimed to evaluate clinical, laboratory and treatment characteristics of children with cyanotic breath holding spells. Methods: Included were 180 children (mean age: 1.82?±?0.53 years) with cyanotic breath holding spells. They were divided into three groups: with iron deficiency, with iron deficiency anemia and without iron deficiency. Blood hemoglobin (HB), ferritin and iron concentrations were measured at baseline and after 3 and 6 months of iron treatment. Results: The mean spell frequency was 24.57?±?7.31/months, 83% had spells after the age of 1 year, 37% had daily spells, 16% had family history of spells, and 61% had Iron deficiency/Iron deficiency anemia (p?=?.001). No significant difference in the frequency of spells between children with iron deficiency and those with Iron deficiency anemia. Compared to patients without iron deficiency, there was significant reduction of spells frequency, increased hemoglobin, ferritin and iron levels after 3 and 6 months of iron therapy (p?=?.0001). Negative correlations were observed between spell frequency with hemoglobin (p?=?.001), ferritin (p?=?.0001) and iron (p?=?.001) levels. Conclusion: Not only Iron deficiency anemia but also iron deficiency alone without anemia is associated with a risk of high-frequency cyanotic breath holding spells. Iron therapy results in reduction in spells’ frequency which was correlated with increasing ferritin and iron levels.     

Interaction between anemia and blood levels of iron,zinc, copper,cadmium and lead in children

Objective Anemia is a widespread problem among infants and children in many parts of the world, and it is often associated with some trace elements (iron, zinc, copper) and heavy metals (cadmium and lead). Aim of this study was to investigate the relationship between anemia and these elements. Methods This research was performed on 256 children (mean age 6.8 ± 0.2) living in Denizli city center. We observed iron deficiency anemia (IDA) in 23 children, iron deficiency without anemia (ID) in 36 children and only anemia (ferritin level normal) (OA) in 18 children, and 179 children were found healthy and they were regarded as controls (C). Blood samples were taken from subjects and the concentrations of zinc, copper, iron, cadmium and lead in serum were measured with atomic absorption spectrophotometer. Results The levels of copper, cadmium and lead in serum were significantly higher in children with IDA than those of controls (p<0.05, p<0.05, p<0.01, respectively). The other elements in the serum of ID were not different from controls.     

Iron deficiency anemia in an urban slum

Objective  Of this pilot study was to assess the iron status and dietary intake of 1–3 year-old apparently healthy toddlers of the lower socio-economic class, and the effect of eight weeks intervention with liquid oral iron in an urban slum in Pune, India. Methods  50 toddlers (M= 25, F= 25) with mean age of 2.4 years (SD 0.82) were evaluated. Anthropometry, Food Frequency Questionnaire, a hemogram and ferritin were measured. Twenty mg of elemental iron was given to all toddlers. After 8 weeks clinical examination, anthropometry, hemoglobin (HGB) and Ferritin were measured. Results  Prevalence of anemia was 66% (HGB <11gm %) and ferritin (iron stores) were low (< 12 μgm/L) in 45 (90%). After therapy prevalence of anemia was 30%. There was a significant difference in the HGB and ferritin levels of children after eight weeks of therapy (p<0.001). Conclusion  The prevalence of anemia decreased from 66 to 30% after treatment with liquid iron. We propose that all concerned in the care of toddlers should join the fight against anemia and prescribe iron to all toddlers when they are seen for minor ailments.     

Evaluation of Erythropoiesis by Serum Transferrin Receptor and Ferritin in Infants Aged 0–6 Months

The aim of this study was to evaluate erythropoiesis in 198 healthy babies aged 0–6 months by determination of their blood count, serum transferrin receptor (STfR), and ferritin levels. Anemia and microcytosis were present in 9% and 13% of the sample, respectively. Microcytosis rate was as high as 45% in 6-month-old babies. In infants with normal blood counts, the values of sTfR/ferritin and sTfR-F index were increasing with the increase of sTfR and decrease of ferritin beginning from 2 months of age. In the 5- to 6-month-old group, sTfR concentrations, sTfR/ferritin ratio, and sTfR-F index were higher in infants with anemia and microcytosis. This research showed a high frequency of iron deficiency detected in otherwise healthy babies. Only problems with early weaning practices were found to be significantly more common in babies with iron deficiency.     

Efficacy of daily and weekly iron supplementation on iron status in exclusively breast-fed infants

Iron deficiency anemia (IDA) remains the most prevalent nutritional deficiency in infants worldwide. The purpose of this study was to determine the efficacy of daily and weekly iron supplementation for 3 months to improve the iron status in 4-month-old, exclusively breast-fed healthy infants. Infants 4 months of age were eligible for the open, randomized controlled trial if their mothers intended to continue exclusive breast-feeding until the infants were 6 months of age. Infants or mothers with iron deficiency (ID) or IDA on admission were excluded. The infants (n = 79) were randomly assigned to three groups, the first group receiving daily (1 mg/kg daily), the second group weekly (7 mg/kg weekly), and the third group no iron supplementation. Anthropometric measurements were taken on admission and at 6 and 7 months of age. Iron status was analyzed on admission and monthly for 3 months. Both hematologic parameters and anthropometric measurements were found to be similar among the three groups during the study period. Seven infants (31.8%) in the control group, six (26.0%) in the daily group, and three (13.6%) in the weekly group developed ID or IDA (P > 0.05). Infants whose mothers had ID or IDA during the study period were more likely to develop ID or IDA independently from iron supplementation. Serum ferritin levels decreased between 4 and 6 months of age in the control and daily groups; the weekly group showed no such decrease. In all groups, the mean levels of serum ferritin were significantly increased from 6 months to 7 months of age during the weaning period. In this study, which had a limited number of cases, weekly or daily iron supplementation was not found to decrease the likelihood of IDA. In conclusion, exclusively breast-fed infants with maternal IDA appeared to be at increased risk of developing IDA.     

中国7个月～7岁儿童铁缺乏症流行病学的调查研究

目的　调查我国儿童铁减少 (ID)、缺铁性贫血 (IDA)及铁缺乏症患病率。方法　采用分层抽样的方法 ,以全国 15个省 ,2 6个市县为调查点 ,随机抽取 9118名 7个月～ 7岁儿童为调查对象 ,检测末梢血血红蛋白 (Hb)、锌原卟啉 (ZPP)、血清铁蛋白 (SF)等指标。结果　 7个月～ 7岁儿童ID32 5 %、IDA 7 8% ;7～ 12个月ID 4 4 7%、IDA 2 0 8% ;13～ 36个月ID 35 9%、IDA 7 8% ;37个月～ 7岁ID 2 6 5 %、IDA 3 5 %。不同年龄组儿童ID、IDA、铁缺乏症患病率由高到低依次为 7～ 12个月 (婴儿组 ) ,13～ 36个月 (幼儿组 ) ,37个月～ 7岁 (学前组 ) ,各年龄组差异有显著意义 (P <0 0 1)。农村婴儿组ID 35 8%、IDA 30 1%、Hb ( 98 8± 9 1)g/L ;城市婴儿组ID 4 8 1%、IDA 16 8%、Hb ( 10 1 0± 6 8)g/L。农村幼儿组ID 31 0 %、IDA 15 5 %、Hb ( 98 2± 10 5 )g/L ;城市幼儿组ID 38 0 %、IDA 4 4 %、Hb( 10 2 8± 6 9)g/L。农村学前儿童组ID 2 7 6 %、IDA 6 3%、Hb( 10 1 2± 8 6 )g/L ;城市学前儿童组ID2 6 0 %、IDA 1 9%、Hb( 10 4 2± 4 4 )g/L。农村 7个月～ 7岁儿童铁缺乏症患病率 4 2 0 % ,城市 7个月～ 7岁儿童铁缺乏症患病率 39 5 % (P <0 0 1)。城市婴儿和幼儿ID患病率显著高于农村 (P <0     

Childhood anemia and iron deficiency in sub-Saharan Africa – risk factors and prevention: A review

Iron deficiency and iron deficiency anemia are public health issues recognised by the World Health Organisation, especially in sub-Saharan Africa. In some countries on this continent, the prevalence of anemia exceeds 60% in the pediatric population. Iron supplementation could prevent around one third of anemia cases in children in Africa and could decrease morbidity and mortality. A number of factors are behind this anemia, including iron deficiency caused by an inadequate diet, pica and geophagia, as well as chronic inflammation (malaria, digestive and urinary parasites, etc.). Ferritin is a good indicator of the body's iron stores, but it is not a specific reflection, with both inflammation and infection causing an increase. Ferritin could be interpreted according to C-reactive protein (CRP) or alpha-1 glycoprotein (AGP), or by adjusting the ferritin threshold to 30 μg/L. The treatment of malaria and digestive or urinary worms, the correction of factors that stimulate inflammation, the fight against geophagia, as well as more hygienic living conditions, are all prerequisites for overcoming iron deficiency. A number of campaigns using iron supplements have proven to be effective, especially in schools, to fight against iron deficiency and malnutrition. Biofortification is an innovative and promising cultivation technique that increases the content of bioavailable iron in local produce such as beans. It will become a lever in the fight against iron deficiency.     

Impact of small‐quantity lipid‐based nutrient supplement on hemoglobin,iron status and biomarkers of inflammation in pregnant Ghanaian women

We examined hemoglobin (Hb, g/L), iron status (zinc protoporphyrin, ZPP, µmol/mol heme, and transferrin receptor, TfR, mg/L) and inflammation (C‐reactive protein, CRP and alpha‐1 glycoprotein, AGP) in pregnant Ghanaian women who participated in a randomized controlled trial. Women (n = 1320) received either 60 mg Fe + 400‐µg folic acid (IFA); 18 micronutrients including 20‐mg Fe (MMN) or small‐quantity lipid‐based nutrient supplements (SQ‐LNS, 118 kcal/d) with the same micronutrient levels as in MMN, plus four additional minerals (LNS) daily during pregnancy. Intention‐to‐treat analysis included 349, 354 and 354 women in the IFA, MMN and LNS groups, respectively, with overall baseline mean Hb and anemia (Hb <100) prevalence of 112 and 13.3%, respectively. At 36 gestational weeks, overall Hb was 117, and anemia prevalence was 5.3%. Compared with the IFA group, the LNS and MMN groups had lower mean Hb (120 ± 11 vs. 115 ± 12 and 117 ± 12, respectively; P < 0.001), higher mean ZPP (42 ± 30 vs. 50 ± 29 and 49 ± 30; P = 0.010) and TfR (4.0 ± 1.3 vs. 4.9 ± 1.8 and 4.6 ± 1.7; P < 0.001), and greater prevalence of anemia (2.2% vs. 7.9% and 5.8%; P = 0.019), elevated ZPP (>60) [9.4% vs. 18.6% and 19.2%; P = 0.003] and elevated TfR (>6.0) [9.0% vs. 19.2% and 15.1%; P = 0.004]. CRP and AGP concentrations did not differ among groups. We conclude that among pregnant women in a semi‐urban setting in Ghana, supplementation with SQ‐LNS or MMN containing 20 mg iron resulted in lower Hb and iron status but had no impact on inflammation, when compared with iron (60 mg) plus folic acid (400 µg). The amount of iron in such supplements that is most effective for improving both maternal Hb/iron status and birth outcomes requires further evaluation. This trial was registered at ClinicalTrials.gov as: NCT00970866.     

Occult blood in stool in exclusively formula fed infants versus exclusively breast fed infants in the first six months of life

BackgroundSince most of infant’s formula are based on cow’s milk to which allergy can occur, and considering the neurodevelopmental consequences of iron deficiency during infancy; we aimed to verify the occurrence of occult intestinal blood loss during the first 6 months of life in response to being fed cow’s milk based formula versus breast milk. We also studied the iron status in order to assess prevalence of iron deficiency anemia.MethodsHealthy full term infants from birth to 6 months who were either exclusively breast fed (BF) (n = 50) or formula fed (FF) (n = 50) were considered for enrollment. Detailed questionnaire describing perinatal period was taken from the mothers. Complete blood count, serum iron, total iron binding capacity (TIBC), serum transferrin and occult blood in stool were requested for each infant.ResultsWe reported no significant differences in hemoglobin, hematocrit and MCV between both groups. FF infants had higher levels of TIBC. We found that 4/50 FF infants had positive occult blood in stool; while only 1/50 BF infants was positive. The prevalence of iron deficiency anemia was higher in the FF group (14%) rather than in the BF group (8%).ConclusionAlthough iron content in formula is higher than breast milk, BF infants attained better iron status than FF infants and the prevalence of anemia among the FF group was higher.     

Iron deficiency among apparently healthy children aged 6 to 24 months in Ibadan,Nigeria

Iron deficiency remains a global public health challenge, with a higher burden in children in the tropics. When it occurs early in life, it may have long-term effects on neurodevelopment. The aims of this study were to assess the iron status of children aged 6–24 months, to determine the prevalence of iron deficiency and its associated factors in Ibadan, Nigeria. The authors conducted a cross-sectional study between March and June 2014. A total of 202 apparently healthy children aged between 6 and 24 months attending 2 major immunization clinics in Ibadan were included. A questionnaire was used to collect information on sociodemographic characteristics, pregnancy and birth history, and nutritional history. Physical examination was carried out on all the subjects, and serum ferritin level was determined using an enzyme-linked immunosorbent assay (ELISA) technique. Iron deficiency was defined using a cutoff value of <30 µg/L. Fifty-nine children (29.2%) had iron deficiency. No clinical features were found to be significantly associated with iron deficiency. Iron deficiency was associated with breastfeeding (P = .020) and younger age (P = .015) in the study population. One hundred and forty-three (70.8%) of the study participants had anemia, and 39 (19.3%) had iron deficiency anemia. The prevalence of iron deficiency among apparently healthy children aged 6–24 months in Ibadan, Nigeria, is high. There is the need for a national policy on routine screening for iron deficiency and iron supplementation for infants and young children as recommended by the World Health Organization.     

Deficiencies in the Management of Iron Deficiency Anemia During Childhood

Limited high‐quality evidence supports the management of iron deficiency anemia (IDA). To assess our institutional performance in this area, we retrospectively reviewed IDA treatment practices in 195 consecutive children referred to our center from 2006 to mid‐2010. The majority of children were ≤4 years old (64%) and had nutritional IDA (74%). In 11‐ to 18‐year‐old patients (31%), the primary etiology was menorrhagia (42%). Many were referred directly to the emergency department and/or prescribed iron doses outside the recommended range. Poor medication adherence and being lost‐to‐follow‐up were common. Substantial improvements are required in the management of IDA.     

Evaluation of erythropoiesis by serum transferrin receptor and ferritin in infants aged 0-6 months

The aim of this study was to evaluate erythropoiesis in 198 healthy babies aged 0-6 months by determination of their blood count, serum transferrin receptor (STfR), and ferritin levels. Anemia and microcytosis were present in 9% and 13% of the sample, respectively. Microcytosis rate was as high as 45% in 6-month-old babies. In infants with normal blood counts, the values of sTfR/ferritin and sTfR-F index were increasing with the increase of sTfR and decrease of ferritin beginning from 2 months of age. In the 5- to 6-month-old group, sTfR concentrations, sTfR/ferritin ratio, and sTfR-F index were higher in infants with anemia and microcytosis. This research showed a high frequency of iron deficiency detected in otherwise healthy babies. Only problems with early weaning practices were found to be significantly more common in babies with iron deficiency.     

福建省儿童铁缺乏症流行病学调查报告

目的 　了解我省儿童铁营养的现状 ,为使儿童缺铁性贫血的患病率在 2 0 0 0年的基础上下降 1 / 3掌握基数。方法 　在全省范围分三个层次九个流调点对 2 584名儿童作Hb(血红蛋白 )、ZPP(锌原卟啉 )及SF(血清铁蛋白 )的测定。结果 　我省儿童总的铁缺乏症发生率 37 2 3% ;铁减少发生率 2 2 87% ;缺铁性贫血发生率 1 4 36 %。结论 　铁缺乏、铁减少及缺铁性贫血的发生率 ,与饮食的合理性有密切关系。