Mandal Sandip K, DE Saumyen, Das Rashmita, Awati Nikahat J, Dey Nilanjana, Biswas Abhijit
Paediatrics, College of Medicine & Sagore Dutta Hospital, Kolkata, IND.
Cureus. 2024 Apr 22;16(4):e58761. doi: 10.7759/cureus.58761. eCollection 2024 Apr.
Background and objective Anemia, particularly iron deficiency anemia (IDA), presents a significant global health challenge, particularly among children under the age of five years in developing nations. Concurrently, febrile convulsions (FC) affect up to 5% of neurologically healthy children aged 6-60 months, causing considerable distress among parents. There is a suggested correlation between fever and iron deficiency, which may exacerbate neurological risks, potentially lowering seizure thresholds and increasing the risk of FC. However, studies investigating the relationship between IDA and FC have shown conflicting results. In light of this, this study aimed to explore this relationship among children aged 6-60 months in Eastern India, an area where this association has yet to be thoroughly investigated. Materials and methods The case-control study included children aged 6-60 months. The cases consisted of children presenting with FC, while controls comprised children in the same age group presenting with febrile illness but without seizures. Informed consent was obtained, a detailed history was taken, and clinical examinations were conducted for both groups. Blood investigations were performed to diagnose IDA according to WHO criteria: hemoglobin <11 gm/dl with the classical triad of low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH), and low mean corpuscular hemoglobin concentration (MCHC) for age. Data analysis was performed using the R-based software Jamovi 2.4.8. with appropriate statistical tests. Results We included 81 cases and 80 controls. The study found a statistically significant association between IDA and FC with an odds ratio (OR) of 2.25 [95% confidence interval (CI): 1.03-4.91; p=0.039]. Additionally, the study revealed that hemoglobin levels, MCH, MCV, and MCHC were lower among cases compared to controls, while the red cell distribution width (RDW) was higher. Both these findings regarding RBC indices were statistically significant (p<0.05). Conclusions Our findings indicate a statistically significant association between IDA and FC among children under five years of age. Implementing measures to prevent IDA and strengthening existing strategies may help alleviate the burden of FC in this vulnerable population.
背景与目的 贫血，尤其是缺铁性贫血（IDA），是一项重大的全球健康挑战，在发展中国家五岁以下儿童中尤为突出。同时，热性惊厥（FC）影响着高达5%的6至60个月神经健康的儿童，给家长带来极大困扰。有观点认为发热与缺铁之间存在关联，这可能会加剧神经风险，潜在地降低癫痫发作阈值并增加热性惊厥的风险。然而，调查IDA与FC之间关系的研究结果相互矛盾。鉴于此，本研究旨在探索印度东部6至60个月儿童中的这种关系，该地区这种关联尚未得到充分研究。
材料与方法 病例对照研究纳入了6至60个月的儿童。病例组为出现FC的儿童，对照组为同年龄组出现发热性疾病但无惊厥的儿童。获得了知情同意，对两组儿童进行了详细病史询问和临床检查。根据世界卫生组织标准进行血液检查以诊断IDA：血红蛋白<11 g/dl，伴有年龄对应的低平均红细胞体积（MCV）、低平均红细胞血红蛋白（MCH）和低平均红细胞血红蛋白浓度（MCHC）的典型三联征。使用基于R的软件Jamovi 2.4.8进行数据分析，并采用适当的统计检验。
结果 我们纳入了81例病例和80例对照。研究发现IDA与FC之间存在统计学显著关联，比值比（OR）为2.25 [95%置信区间（CI）：1.03 - 4.91；p = 0.039]。此外，研究表明病例组的血红蛋白水平、MCH、MCV和MCHC低于对照组，而红细胞分布宽度（RDW）则较高。关于红细胞指数的这两项发现均具有统计学显著性（p < 0.05）。
结论 我们的研究结果表明，五岁以下儿童中IDA与FC之间存在统计学显著关联。采取预防IDA的措施并加强现有策略可能有助于减轻这一脆弱人群中FC的负担。
