Pasricha Sant-Rayn, Caruana Sonia R, Phuc Tran Q, Casey Gerard J, Jolley Damien, Kingsland Sally, Tien Nong T, MacGregor Lachlan, Montresor Antonio, Biggs Beverley-Ann
Department of Medicine (RMH/WH), The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Am J Trop Med Hyg. 2008 Mar;78(3):375-81.
Iron deficiency anemia poses an important public health problem for women of reproductive age living in developing countries. We assessed the prevalence of iron deficiency and anemia and associated risk factors in a community-based sample of women living in a rural province of northwest Vietnam. A cross-sectional survey, comprised of written questionnaires and laboratory analysis of hemoglobin (Hb), ferritin, transferrin receptor, and stool hookworm egg count, was undertaken, and the soluble transferrin receptor/log ferritin index was calculated. Of 349 non-pregnant women, 37.53% were anemic (Hb < 12 g/dL), and 23.10% were iron deficient (ferritin < 15 ng/L). Hookworm infection was present in 78.15% of women, although heavy infection was uncommon (6.29%). Iron deficiency was more prevalent in anemic than non-anemic women (38.21% versus 14.08%, P < 0.001). Consumption of meat at least three times a week was more common in non-anemic women (51.15% versus 66.67%, P = 0.042). Mean ferritin was lower in anemic women (18.99 versus 35.66 ng/mL, P < 0.001). There was no evidence of a difference in prevalence (15.20% versus 17.23%, P = 0.629) or intensity (171.07 versus 129.93 eggs/g, P = 0.412) of hookworm infection between anemic and non-anemic women. Although intensity of hookworm infection and meat consumption were associated with indices of iron deficiency in a multiple regression model, their relationship with hemoglobin was not significant. Anemia, iron deficiency, and hookworm infection were prevalent in this population. Intake of meat was more clearly associated with hemoglobin and iron indices than hookworm. An approach to addressing iron deficiency in this population should emphasize both iron supplementation and deworming.
缺铁性贫血对生活在发展中国家的育龄妇女构成了一个重要的公共卫生问题。我们评估了越南西北部一个农村省份社区中妇女缺铁和贫血的患病率以及相关危险因素。开展了一项横断面调查，包括书面问卷调查以及对血红蛋白（Hb）、铁蛋白、转铁蛋白受体和粪便钩虫卵计数进行实验室分析，并计算可溶性转铁蛋白受体/对数铁蛋白指数。在349名非妊娠妇女中，37.53%患有贫血（Hb<12 g/dL），23.10%缺铁（铁蛋白<15 ng/L）。78.15%的妇女存在钩虫感染，不过重度感染并不常见（6.29%）。缺铁在贫血妇女中比非贫血妇女更为普遍（38.21%对14.08%，P<0.001）。非贫血妇女中每周至少食用三次肉类更为常见（51.15%对66.67%，P = 0.042）。贫血妇女的平均铁蛋白较低（18.99对35.66 ng/mL，P<0.001）。没有证据表明贫血和非贫血妇女在钩虫感染患病率（15.20%对17.23%，P = 0.629）或感染强度（171.07对129.93个虫卵/克，P = 0.412）上存在差异。尽管在多元回归模型中钩虫感染强度和肉类消费与缺铁指标相关，但它们与血红蛋白的关系并不显著。贫血、缺铁和钩虫感染在该人群中普遍存在。肉类摄入与血红蛋白和铁指标的关联比钩虫更为明显。解决该人群缺铁问题的方法应同时强调铁补充和驱虫。
