Urkin J, Adam D, Weitzman D, Gazala E, Chamni S, Kapelushnik J
Primary Pediatric Care Unit, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Acta Paediatr. 2007 Jun;96(6):857-60. doi: 10.1111/j.1651-2227.2007.00271.x. Epub 2007 Apr 27.
To estimate the prevalence of iron deficiency and iron deficiency anaemia using haematological indices.
Prospective interventional study. Healthy toddlers from Bedouin and Jewish towns in southern Israel. Capillary blood was sampled to assess iron status and nutritional history recorded. Parents were given specific nutritional instructions. Anaemia was defined as haemoglobin level < or = 11 gr/dL. Iron deficiency without anaemia was defined as mean corpuscular volume (MCV) < 70 fL and/or red blood cell width (RDW) > or = 16, with haemoglobin level > 11 gr/dL. Toddlers with iron deficiency were treated with 5 mg/kg/day of elemental iron. Follow-up iron and nutritional status was performed 1 and 2 months after enrolment.
At the time of enrolment 42% of the 107 Jewish and 93% of the 43 Bedouin toddlers were iron deficient (p < 0.001). Significantly higher proportions of Bedouin toddlers were breastfed, drank tea, did not eat meat, did not take supplementary iron in their first year of life and were previously diagnosed with anaemia. Rate of follow-up was 55% among Bedouins and 33% among Jews. The mean haemoglobin rise over two months was 0.91 gr/dL (95% CI: 0.63-1.18 gr/dL; p < 0.001) in Bedouins and 0.58 gr/dL (95% CI: 0.14-1.02 gr/dL; p = 0.014) in Jews.
Higher rates of anaemia and iron deficiency, as well as most of the risk factors, found among the Bedouin toddlers, call for the design and implementation of innovative, culturally appropriate interventions in the Bedouin population.
通过血液学指标评估缺铁及缺铁性贫血的患病率。
前瞻性干预研究。选取以色列南部贝都因族和犹太族城镇的健康幼儿。采集毛细血管血以评估铁状态并记录营养史。向家长提供特定的营养指导。贫血定义为血红蛋白水平≤11克/分升。缺铁但无贫血定义为平均红细胞体积(MCV)<70飞升和/或红细胞分布宽度(RDW)≥16,且血红蛋白水平>11克/分升。缺铁的幼儿接受每日5毫克/千克元素铁的治疗。在入组后1个月和2个月进行铁及营养状况的随访。
入组时,107名犹太幼儿中有42%缺铁,43名贝都因幼儿中有93%缺铁(p<0.001)。贝都因幼儿中母乳喂养、喝茶、不吃肉、在出生第一年未补充铁剂以及既往被诊断为贫血的比例显著更高。贝都因族的随访率为55%,犹太族为33%。贝都因族幼儿在两个月内血红蛋白平均升高0.91克/分升(95%可信区间:0.63 - 1.18克/分升;p<0.001),犹太族幼儿为0.58克/分升(95%可信区间:0.14 - 1.02克/分升;p = 0.014)。
贝都因族幼儿中贫血和缺铁的发生率较高,以及大多数危险因素,都需要针对贝都因人群设计并实施创新的、符合文化背景的干预措施。