Saha Somen, Puwar Tapasvi, Shah Komal, Pandya Apurvakumar, Wanjari Mayur B, Saxena Deepak
Public Health, Indian Institute of Public Health Gandhinagar, Gandhinagar, IND.
Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.
Cureus. 2022 Aug 29;14(8):e28565. doi: 10.7759/cureus.28565. eCollection 2022 Aug.
Introduction Anemia is an important public health concern, affecting almost 25% of the global population. In India, these statistics are even more worrisome with more than half of the children, non-pregnant and pregnant women being affected by the disease. Though the major cause of anemia is iron deficiency, other causes cannot be neglected considering the magnitude of the problem. The present study was designed to estimate the prevalence of non-iron deficiency anemia (NIDA) in Devbhoomi Dwarka District of Gujarat. Methods For this cross-sectional study, total of 258 mothers (antenatal and postnatal) were enrolled from 27 primary health centers. Apart from demographic details and obstetric history, hemoglobin and ferritin levels were measured from the participant's blood after obtaining consent. Clinical information such as the history of recent illness and fever were also noted through questionnaires. Prevalence was anemia was calculated using a standard threshold of blood hemoglobin and NIDM was defined using ferritin levels. Results As per hemoglobin levels, anemia was present in 65.9% of the mothers, which was relatively higher in antenatal women (90%) as compared to postnatal women (57%). Ferritin levels showed that out of this total anemic mothers, 61.8% (105/258) have normal ferritin levels indicating the presence of non-iron deficiency. Trimester-wise analysis of anemia in AN showed that NIDM prevalence increases with increasing trimester in contrast to IDA where a considerable reduction was found with iron supplementation. Conclusion The study indicated that two out of every three women were anemic and only one out of four were anemic with depleted iron storage. These findings have important policy implications as in India the anemia control programs address only iron deficiency anemia and not NIDA. The development of a framework for diagnosis and appropriate treatment can be recommended for integration into national guidelines.
引言
贫血是一个重要的公共卫生问题，影响着全球近25%的人口。在印度，这些统计数据更令人担忧，超过一半的儿童、非孕妇和孕妇受到该疾病的影响。尽管贫血的主要原因是缺铁，但考虑到问题的严重性，其他原因也不能忽视。本研究旨在估计古吉拉特邦德夫布霍米·德瓦尔卡区非缺铁性贫血（NIDA）的患病率。
方法
在这项横断面研究中，从27个初级卫生中心招募了总共258名母亲（产前和产后）。除了人口统计学细节和产科病史外，在获得参与者同意后，测量其血液中的血红蛋白和铁蛋白水平。还通过问卷记录了近期疾病和发烧史等临床信息。使用血红蛋白的标准阈值计算贫血患病率，并使用铁蛋白水平定义NIDM。
结果
根据血红蛋白水平，65.9%的母亲患有贫血，其中产前妇女（90%）的贫血率高于产后妇女（57%）。铁蛋白水平显示，在这些贫血母亲中，61.8%（105/258）的铁蛋白水平正常，表明存在非缺铁性贫血。对产前贫血进行的按孕期分析表明，与缺铁性贫血（IDA）不同，非缺铁性贫血患病率随孕期增加而上升，缺铁性贫血在补充铁剂后患病率大幅下降。
结论
该研究表明，每三名女性中就有两名贫血，而每四名贫血女性中只有一名铁储存耗尽。这些发现具有重要的政策意义，因为在印度，贫血控制项目仅针对缺铁性贫血，而非缺铁性贫血。建议制定一个诊断和适当治疗的框架，以纳入国家指南。
