Background: Anemia poses a considerable global public health issue, leading to high rates of illness and death, increased hospitalizations, and setbacks in socio-economic progress. Iron deficiency anemia is recognized as the predominant cause of this burden worldwide. Infants and young children are especially vulnerable to anemia, particularly iron deficiency, which significantly impacts community health. Globally, iron deficiency is the most prevalent and widespread nutritional disorder affecting people of all ages, with notably high prevalence rates observed among children in developing countries, where it can affect up to half of infants aged 12 months in some areas. Aims and objectives:To study the association of Iron Deficiency Anemia among different age groups in paediatric population, with respect to severity of Anemia. Methods: This is a descriptive cross sectional study was conducted at the department of paediatrics, Dr. Vitthalrao Vikhe Patil Pravara Rural hospital Loni, Maharastra, India, performed on children aged 6 months to 12 years coming to Paediatrics department from June 2022 to June 2024. Results: Out of 112 cases of Iron Deficiency Anemia, 19 cases (17%) were of Mild Anemia, 53 cases(47%) were of Moderate Anemia and 40 cases(36%) were of Severe type of Anemia. And 99 cases(88.4%) are from 6 months to 59 months age group and 13 cases (11.6%) are from 5 years to 11 years. Conclusion: Iron Deficiency Anemia is common among the low socio-economic classes in the rural areas of Western Maharashtra, leading to a significant morbidity during early childhood in the form of poor growth rates, easy susceptibility to infections and illnesses, pica which may lead to accidental poisoning, seizures and long term motor, cognitive and socio-emotional behavioral deficits. Therefore it is necessory to screen the school aged children, regularly to avoid the complications realated to Iron Deficiency Anemia, by proper dietary councelling and early initiation of Iron supplements in susceptible groups.
In countries like India, children fall an easy prey to anemia as majority of them are ill-fed, ill-clothed with undernourishment, due to poverty and ignorance. Anemia is a global public health problem associated with high morbidity and mortality rates, increased hospitalisation and a reverse effect on socioeconomic development.1-3
Anemia in infancy is associated with long lasting effects on the brain and behaviour leading to poor motor, cognitive and socio-emotional functions.4-5 Globally, the nutritional status of school aged children impacts their health, cognition and subsequently their educational achievement.6-7
Iron deficiency anemia is known to be the most important contributing factor to the global burden of the disease.8
WHO estimates of 2011 suggested about 273 million children had anemia worldwide.8
Globally, it has been found that children have the highest prevalence of anemia (42.6%).9-10. When and where around 35.7 million children were estimated to have anemia, of whom 48.6% were aged 6-59 months.9, with school aged children worldwide account for 25% of the anemia burden.11
Infants and young children are vulnerable to anemia especially iron deficiency, which represents a public health problem with defined impacts on the health of communities.12 Evidence suggest that early infant feeding practices play a major role in the prevalence of iron deficiency and anemia due to it.13-14. Globally iron deficiency is the most common and widespread nutritional disorder affecting all age groups, particularly in children in developing countries where prevalence as high as 50% has been reported among infants aged 12 months in some countries. Iron deficiency anemia is a leading cause of mortality and morbidity among infants worldwide and some of its manifestations are possibly irreversible.15-22. Iron deficiency represents one of the three most common micronutrient deficiencies in addition to iodine and vitamin A.23.
In exclusively breastfed infants up to 6 months of age, prevalence of iron deficiency anemia is 27%, whereas it is 16.7% in infants fed formula milk and 100% in infants fed cow milk.24.
A prevalence rate of over 65% in preschool children has been reported in various studies undertaken in rural and urban India.25. By all accounts, India falls in the category of high magnitude prevalence for anemia.
This is a descriptive cross-sectional study conducted at the department of paediatrics, Dr. Vitthalrao Vikhe Patil Pravara Rural hospital Loni, Maharastra, India, on children aged 6 months to 12 years coming to Pediatric department and diagnosed with Iron deficiency Anemia. Study period was between June 2022 to June 2024. Our study was approved by the Institutional Ethics Committee. Inclusion criteria Children aged between 6 months and 12 years admitted to the Department of Pediatrics, PRH, Loni, diagnosed with iron deficiency anemia or presenting with iron deficiency anemia alongside other co-morbidities. Parents or legal guardians of the patients who are willing to provide consent for their child's participation in this study.
Exclusion criteria - Children with thalassemia or other hemolytic anemias.
Anemia due to chronic diseases such as chronic kidney disease or tuberculosis.
Children with sepsis or significant inflammation. Children admitted with us, were examined thoroghly for pallor and Iron studies (serum iron, serum ferritin, TIBC) were sent after ruling out exclusion criteria. Cases of Iron Deficiency Anemia are diagnosed and were distributed among the cases of anemia according to the severity and age of presentation. After considering all the necessary investigations, iron supplements were started and the patients are followed up regularly with necessary blood investigations.
STATISTICAL ANALYSIS:
Data obtained in history, clinical examination and investigation proforma was entered in excel sheet and subjected to appropriate statistical analysis. Data obtained in history, clinical examination and investigation proforma was entered in excel sheet and analysis using SPSS software for ver 25.0.
Out of 112 cases of laboratory proven Iron Deficiency Anemia, 19 cases (17%) were of Mild Anemia, 53 cases(47%) were of Moderate Anemia and 40 cases(36%) were of Severe type of Anemia.
Among the total 112 cases of Iron Deficiency Anemia, 99 cases(88.4%) were from 6 months to 59 months age group and 13 cases (11.6%) are from 5 years to 11 years, there is a significant association with a P value of 0.05.
Severity of Anemia |
6 months to 59 months |
5 years to 11 years |
Total |
P value |
Mild Anemia |
19 (100%) |
0 |
19 |
0.05 |
Moderate Anemia |
49 (92.5%) |
4 (7.5%) |
53 |
|
Severe Anemia |
31 (77.5%) |
9 (22.5%) |
40 |
|
Grand Total |
99 (88.4%) |
13 (11.6%) |
112 |
Study |
Mild anemia |
Moderate anemia |
Severe anemia |
Our study |
0 |
31 (13.5%) |
12 (5.2%) |
Sastri et al.26 |
20 (18.1%) |
30 (27.2%) |
60 (54.7%) |
The studies available on Iron Deficiency Anemia, in most of the cases, were done on school going children. From 6 months to 59 months age group, very few studies were done on Anemia, but haven’t mentioned about Iron Deficiency in detail. Sastri et al.26. did a study in 5 years to 12 years age group, so comparing our data with Sastrio et al.’s data. Sastri et al.26 did the study in 5 years to 12 years age group (n=110)and divided them according to severity of Anemia, involving 18.1% in Mild, 27.2% in Moderate and 54.7% in Severe forms of Anemia.
Conflict of interest: we have no conflict of interest.
Ethical approval: the study was approved by the institutional ethics committee.