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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1975 and 1983 health care expenditures in Ghana dropped to a low point as a consequence of the structural readjustment program instituted by the World Bank. During 1975-76 only 15% of available funds were spent on primary health care (PHC), which was officially introduced in the late 1970s. PHC made up 20-25% of the health care expenditures by 1991 with about 25% of health personnel engaged in PHC. 2/3 of health care delivery covered urban areas when 60% of the population lived in the countryside. The district of Ejisu-Juaben in the Ashanti region had high morbidity. Tetanus, polio, whooping-cough, and diphtheria had been brought under control, but measles, diarrhea, and malnutrition were still widespread among children under 5 years old. Malaria, bilharzia, intestinal parasites, respiratory infections, hepatitis, anemia, hypertension, and vitamin A deficiency were also grave problems. AIDS was on the rise. Child mortality amounted to 130/1000 live births and maternal mortality to 1400/100,000 cases. The medical structure of the district comprises 10 health posts (6 governmental and 4 mission). Only 72 villages and 120,000 people are cared for. Each post has a mobile team. In 1993 a new community-based health care program began funded by Save the Children Netherlands. In 60 villages a village health committee existed but they were substandard. They were either reactivated or new committees were set up. Training activities were also started in prenatal care, delivery, care of malnutrition and diarrhea, hygiene, and sanitation. Two years later safe motherhood indicators had improved; postnatal care increased from 16% to 49%; medical deliveries increased from 27% to 37%; the share of families with contraceptive acceptance increased from 7% to 21%; and tetanus vaccination among mothers was estimated to have increased from 27% to 86%.
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PMID:[Primary health care in Ghana: no pay no cure?]. 750 Oct 68

The adoption and implementation of the structural adjustment programme (SAP) in the 1980's by many African countries as a strategy for economic recovery has increased the magnitude of hunger and protein-energy malnutrition, vitamin A deficiency and anaemia. In addition population growth rate has continued to outstrip the food supply at a time when real income value has fallen, thereby diminishing further the access of the poor to nutritious food. Even though Africa's present food supply situation is inadequate and in some cases unsustainable it is reassuring to note that Africa can feed itself provided the potential of doing so is mobilized and sustained. This paper proposes and highlights strategies for the development of a nutrition strategy and nutrition education programmes with emphasis on nutrition programmes which benefit the vulnerables. The paper further proposes that specific policies should be targeted at the poor while instituting food subsidies schemes for those who are most at risk nutritionally.
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PMID:Sustaining nutrition security in Africa under changing socio-economic condition. 776 Oct 43

PAHO member countries maintain food and nutrition surveillance systems. The prevalence of malnutrition among children aged 0-4 in Latin American and Caribbean countries ranges from 0.8% in Chile to 38.5% in Guatemala. It is 2.9% in the US. Low height-for-age is most common among children aged 0-4 in Guatemala (57.9%), Bolivia (38.3%), Peru (35.2%), and Ecuador (34%). The interval between observations of malnutrition prevalence ranged from 22 years in Honduras to 3-4 years in Nicaragua and Panama. Overall, there was a downward trend in malnutrition rates in the Americas. Yet, malnutrition is increasing in Guatemala and Panama. Breast feeding, good weaning practices, appropriate feeding during disease episodes, nutrition education, and programs for immunization and control of diarrhea and respiratory diseases account for the downward trend. Anemia rates among pregnant women (=or 11 g Hb/dl) vary from 13% in Asuncion, Paraguay, to 61% in Misiones, Argentina. Those for preschoolers range from 22% to 45% in Brazil and 27% to 53% in Peru. The prevalence of goiter is more than 50% in Merida, Venezuela, and Chameza, Colombia. It differs greatly in different areas within the same country. Most countries have laws requiring iodination of all salt for human consumption, yet violations are common. Certain areas of the countries in the Americas have vitamin A deficiency rates ranging from 5% to 48.8%. Some countries have enacted laws for sugar enrichment with retinol palmitate to reduce vitamin A deficiency. During the 1970s, deaths from chronic diseases related to nutrition increased 105% in South America, 56% in Central America, Mexico, and Panama, and 21% in the Caribbean. Prevalence of obesity among children aged 0-6 varies from 2.2% in Nicaragua and Brazil to 10.7% in Chile. Adult obesity is most common in Uruguay (about 50%). It is more common among females than males. The highest rates among 20-29 year olds are in Chile, Costa Rica, Cuba, and Peru. The US adult obesity rate is 12%.
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PMID:Nutritional situation in the Americas. 799 15

Helminth and schistosome infections occur in the same geographical areas as does malnutrition. These parasitic infections can occur already in malnourished persons. Hookworm infections reduces food intake and/or increase nutrient wastage via vomiting, diarrhea, or blood loss. These effects exasperate protein energy malnutrition, anemia, and other nutrient deficiencies. Hookworm infection reduces the work capacity and productivity of children and adults; increases maternal and fetal morbidity, premature delivery, and low birth weight, as well as the susceptibility to other infections; and reduces the rate of cognitive development. These social and economic consequences in turn reduce the ability of people and families to raise crops or earn enough money to buy food and other essentials. As many as 90% of the children in some areas of the developed world are infected with roundworm. More than 100,000 deaths in 1987 resulted from complications of roundworm infection (e.g., intestinal obstruction). Roundworm infection reduces the body's ability to use protein and to absorb fat, which worsens protein energy malnutrition. Other nutrient effects of roundworm infection are exacerbation of vitamin A deficiency and lactose and milk intolerance. Whipworm infection can effect prolapse of the rectum and nutritional problems. Treatment of children with whipworm improves hematocrit, growth rates and anthropometry, and serum albumin, and reduces diarrhea and bacterial and protozoan infections in the bowel. Schistosomiasis causes nutritional effects similar to those of helminths. Studies in Kenya show that, in children, 1 treatment against worm, infections improves growth and fitness within 4 months. Other studies in Kenya show that treating children for worms or anemia improves weight gains per month at least as much as and usually more than school feeding programs, a more labor intensive, complicated, and expensive effort. Deworming programs should operate in areas where undernutrition exceeds 25% and worms are prevalent.
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PMID:Helminth parasites, a major factor in malnutrition. 801 83

To compare the changes in Fe metabolism during the development of vitamin A and Fe deficiencies, rats were given either a control diet with sufficient Fe (35 mg added Fe/kg feed) and retinol (1200 retinol equivalents/kg feed), a diet without added vitamin A or a diet with sufficient vitamin A but only 3.5 mg added Fe/kg feed. During a period of 10 weeks, indicators of vitamin A and Fe status were monitored. Neither vitamin A nor Fe deficiency produced clinical signs. Fe deficiency induced an immediate fall in blood haemoglobin concentration. Vitamin A deficiency produced a mild anaemia as the first change in Fe metabolism, pointing to impaired erythropoiesis. This effect was followed by a rise in Fe absorption and an increased amount of Fe in the spleen. By the end of the study, blood haemoglobin, packed cell volume, plasma Fe and Fe content in kidney and femur had increased above control levels, while total Fe-binding capacity had decreased. We speculate that the initial anaemia was masked later by haemoconcentration. The decrease in Fe mobilization, shown by lower total Fe-binding capacity, and the increase in Fe absorption may have caused the observed continuous rise in tissue Fe concentration in rats with vitamin A deficiency. In the rats with Fe deficiency, low tissue Fe levels coincided with high Fe absorption and high total Fe-binding capacity. Thus, changes in Fe metabolism with vitamin A deficiency differed from those with Fe deficiency.
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PMID:Comparison between time-dependent changes in iron metabolism of rats as induced by marginal deficiency of either vitamin A or iron. 805 24

Severe vitamin A deficiency in rats is known to cause anaemia associated with growth retardation and impaired water retention. However, study of the effect of marginal vitamin A intake is of more interest because such intake may mirror the situation in humans in many developing countries. Therefore, in two experiments, the effect of marginal vitamin A deficiency on Fe status was investigated in male rats. After 28 d of feeding either low- or high-vitamin A diets (0 or 120 v. 1200 retinol equivalents/kg feed), body weight and feed intake were not influenced by the level of vitamin A in the diet. Liver weight was lowered by vitamin A deficiency. Water intake was not influenced in rats fed on a low-vitamin A diet. Plasma retinol concentrations were decreased in rats fed on diets low in vitamin A. Marginal vitamin A deficiency produced slightly lower blood haemoglobin concentrations; it did not systematically affect packed cell volume. The concentration of Fe in liver was significantly higher when diets low in vitamin A were fed, but hepatic Fe mass was not affected. Significantly lower Fe levels were observed in femurs of rats with vitamin A deficiency. The effects on liver and femur Fe concentrations were seen with diets adequate in Fe but not with diets deficient in Fe. The efficiency of apparent Fe absorption was significantly increased by low intakes of vitamin A, provided that the dietary Fe concentration was adequate. It is speculated that depressed uptake of Fe by bone marrow is the primary feature of altered Fe status in rats with marginal vitamin A deficiency.
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PMID:Iron status in rats fed on diets containing marginal amounts of vitamin A. 829 15

Serum retinol and hemoglobin levels were determined in 532 children aged 6-60 months living in urban slums of Karachi, Pakistan. Overall 67% (358 of 532) of children had hemoglobin levels of less than 11 g/dl, the World Health Organization definition of anemia for this age group. Estimations for red blood cell indices (hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red blood cell count) were done on a sample of 391 children to classify anemia morphologically. A similar percentage (69.8% [273 of 391 children]) of anemia was found in this group. The anemia was predominantly microcytic and hypochromic. Normocytic normochromic anemia was present in only 16.5%. Serum retinol levels were significantly correlated with hemoglobin (P < 0.002), hematocrit (P < 0.01), and red blood cell (P < 0.001) levels. However, anemia was found to be a poor predictor (positive predictive value [PPV] = 2.5%) for the presence of vitamin A deficiency (retinol < 10 micrograms/dl). The PPV increased to 54% if 20 micrograms/dl, which is an indicator of marginal vitamin A status, was used as the cutoff point. The sensitivity of the hemoglobin test was found to be 75% in correctly identifying vitamin A deficiency when retinol levels of 10 micrograms/dl and 20 micrograms/dl were both used as the cutoff points for deficiency. The specificity for the hemoglobin test varied from 33% to 40% when levels of 10 micrograms/dl and 20 micrograms/dl were used as the cutoff points for vitamin A deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is anemia an accurate predictor of vitamin A status in Pakistani children? 835 91

The author briefly reviews the current status of child nutrition in India and identifies priority actions to be taken over the coming decade so that the nutrition goals set for the year 2000 may be met. Maternal nutrition and low birth weight, lactation performance and infant growth, child mortality, major nutritional problems, protein energy malnutrition, vitamin A deficiency, nutritional anemia, and iodine deficiency disorders are all problem areas of concern which must be addressed and ameliorated. Each topic is discussed in turn. Relatively inexpensive, time tested, and well-proven technologies are available to confront existing nutritional problems, but they need to be implemented. Revising current strategies and shifting the focus from severe to milder forms of malnutrition, with more emphasis on long term sustainable actions, may even allow the nutrition goals set for the year 2000 to be realized. Improving the educational and social status of women, obtaining better health care facilities, environmental sanitation, and general community development are also important elements of improving the nutritional status of children
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PMID:Child nutrition in India: priorities for the coming decade. 837 3

The relationship between ocular manifestation of vitamin A deficiency and children's anaemic/morbidity status as well as the efficacy of vitamin A prophylaxis in preventing these conditions was determined. The prevalence of xerophthalmia in morbid children with anaemia and history of worm infestation, measles, and diarrhoea was higher as compared to their non-morbid counterparts. The relative risk (RR) of anaemic children with eye signs was significantly higher (1.5), but the chances of having anaemia were similar in both vitamin A receivers and non-receivers. The RR of history of worm infestation, measles, and severe diarrhoea was 1.4, 1.0, and 1.2, respectively, in children with eye signs and 1.2, 0.8, and 1.3, respectively in children who did not receive vitamin A prophylaxis. The RR for occurrence of diarrhoea along with vitamin A deficiency was as high as 1.9. It appears xerophthalmia and anaemia co-exist and vitamin A supplementation helps in curbing these conditions among 1-6-year-old children.
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PMID:Xerophthalmia, vitamin A supplementation and morbidity in children. 849 70

Studies with anaemic children and pregnant women from areas where vitamin A deficiency is endemic have shown a beneficial effect on Fe status of supplemental vitamin A in addition to Fe supplementation. This suggests a relationship between vitamin A and Fe status, which we attempted to mimic in rats with anaemia and chronic vitamin A deficiency. Male rats were fed on Fe-adequate diets (35 mg Fe/kg) containing different levels of vitamin A (1200, 450, 150, 75 and 0 retinol equivalent (RE)/kg feed) until they were 5 weeks old. These diets were identical to the diets fed to their mothers. Then the young male rats were transferred to diets containing the same levels of vitamin A but no added Fe. After another 2 weeks the rats were repleted with Fe (35 mg/kg feed) without or with vitamin A to a level of 1200 RE/kg feed. Increased vitamin A intake by the groups previously fed on diets with either 0 or 75 RE/kg produced a reduction in blood haemoglobin concentration, packed cell volume and erythrocyte count. In the group which had been fed on the diet without vitamin A, supplemental vitamin A raised mean cell volume, plasma Fe concentration and total Fe-binding capacity. Vitamin A supplementation during the period of Fe repletion produced a decrease in splenic and tibia Fe concentration, the effect being greater with increasing severity of previous vitamin A deficiency. The paradoxical effect of supplemental vitamin A on haemoglobin, packed cell volume and erythrocyte count can be explained by a decrease in the degree of haemoconcentration. Thus, the positive effect of supplemental vitamin A seen in humans is also observed with rats under controlled experimental conditions. We speculate that supplemental vitamin A during Fe repletion contributes to optimum erythropoiesis and Fe mobilization when baseline vitamin A status is impaired.
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PMID:Supplemental vitamin A enhances the recovery from iron deficiency in rats with chronic vitamin A deficiency. 867 14


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