Yalçın S Songül, Tezel Başak, Yurdakök Kadriye, Pekcan Gülden, Ozbaş Sema, Köksal Eda, Tunç Bahattin, Sahinli Selvi, Altunsu A Tanju, Köse M Rifat, Buzgan Turan, Akdağ Recep
Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2013 Jan-Feb;55(1):16-28.
During the second year of the "Iron-like Turkey" Project, in which all children aged 4-6 months in Turkey receive iron supplementation for 5 months, we aimed to assess the utilization of iron supplementation in the field, as well as the prevalence of anemia in healthy infants aged 12-23 months, while determining a variety of sociodemographic and nutritional factors for anemia in three of the 12 NUTS (Nomenclature of Territorial Units for Statistics) regions (regions with the highest, lowest and middle under-5 malnutrition levels). In a community-based, cross-sectional survey using a multi-staged, weighted, cluster-selected sample, children aged 12-23 months with birthweight ≥2500 g, no chronic illness, no history of blood disease, and from term and singleton pregnancy were enrolled; 1589 children met the criteria. The mean±SD age of children surveyed was 17.8±3.6 months. Of the parents, 72.4% claimed that their physician had recommended iron supplementation, and 68.8% had given supplementation to their children. Overall prevalence of anemia was 7.3%. Multivariate analysis revealed that the frequency of anemia decreased significantly in older infants, when supplementation was recommended by health providers, when an infant was breastfed longer than 6 months, and when the mother received iron supplementation during pregnancy. However, anemia prevalence increased when the infant received iron supplementation at a later age (³9 months), lived in a crowded family (³6 persons), and when the mother had a history of iron deficiency anemia. Anemic infants had significantly lower z scores of weight for age than non-anemic ones. This survey suggests that iron supplementation during pregnancy, initiation of iron supplementation in infants at 4-6 months of age, effective counseling on supplementation, subsequent compliance, support of breastfeeding, and effective training of health care personnel are effective strategies for prevention of anemia in the community.
在“钢铁般的土耳其”项目的第二年，该项目为土耳其所有4至6个月大的儿童提供为期5个月的铁补充剂，我们旨在评估该补铁剂在实际应用中的情况，以及12至23个月健康婴儿的贫血患病率，同时确定12个统计区域单位命名法（NUTS）区域中三个地区（五岁以下儿童营养不良水平最高、最低和中等的地区）贫血的各种社会人口学和营养因素。在一项基于社区的横断面调查中，采用多阶段、加权、整群抽样的样本，纳入出生体重≥2500克、无慢性病、无血液病史、足月单胎妊娠的12至23个月儿童；1589名儿童符合标准。接受调查儿童的平均年龄±标准差为17.8±3.6个月。在家长中，72.4%声称他们的医生曾建议补充铁剂，68.8%已给孩子补充过铁剂。贫血的总体患病率为7.3%。多变量分析显示，年龄较大的婴儿、卫生保健人员建议补充铁剂、婴儿母乳喂养超过6个月以及母亲在孕期接受铁补充剂时，贫血发生率显著降低。然而，婴儿在较晚年龄（≥9个月）开始补充铁剂、生活在拥挤家庭（≥6人）以及母亲有缺铁性贫血病史时，贫血患病率会增加。贫血婴儿的年龄别体重Z评分显著低于非贫血婴儿。这项调查表明，孕期补充铁剂、婴儿在4至6个月大时开始补充铁剂、提供有效的补铁咨询、后续的依从性、支持母乳喂养以及对医护人员进行有效培训是社区预防贫血的有效策略。
