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Query: UMLS:C0162316 (iron deficiency anemia)
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Iron deficiency anaemia is a most common micronutrient deficiency affecting mostly the low socioeconomic populations of the developing world. The objective of this study was to evaluate the feasibility of iron fortification of household drinking water to prevent iron deficiency anaemia among members of the low socioeconomic families of Southern Brazil. A total of 21 low socioeconomic families representing 88 subjects including 1-6 years old children whose haemoglobin level was between 10 and 12 g/dl were selected to participate in this study. Nine families in the control group were supplied with placebo solution and 12 families in the experimental group were supplied iron solution with ascorbic acid to be added to their domestic drinking water over a period of 4 months. The feasibility and acceptability of iron fortified drinking water was assessed through home visits and questionnaires. Blood samples were collected at the beginning and after 4 months of the study for the determination of haemoglobin and serum ferritin levels. The results of this study indicated that iron fortified drinking water was well received by the low socioeconomic families and that it was effective in improving the haemoglobin and serum ferritin levels. It can be concluded from this study that iron fortification of household drinking water is a simple and effective alternative for developing countries along with other technological approaches to iron fortification of foods.
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PMID:Iron fortification of domestic drinking water to prevent anemia among low socioeconomic families in Brazil. 873 76

This paper explores a variety of strategies and policies in Nigeria that may enhance women's "caring capacity" for the food and nutrition security of their children and families. The options that are discussed include increased income for women, women's control of income, investment in women's education, increased access to credit for productive options, increased access to labor-saving technologies, strengthening rights to land and property, creating demands for women's health services and basic health services, and improving access to nutrition information and appropriate social security programs. Nigerian people suffer from increased stunting, wasting, low birth weight, leanness, high infant mortality, iron deficiency anemia, and vitamin A deficiencies. Food shortages exacerbate the nutrition crisis. Infants, young children, and women experience poor nutrition in Nigeria. One way of coping with poor nutrition is the promotion and strengthening of caring capacity, which is the optimal use of household resources to protect and care for the sick child or other vulnerable member of the community, such as the disabled or elderly. Programs can be put in place to enhance female caring ability. For instance, findings indicate that educated women farmers achieve higher productivity levels compared to uneducated women. A Pakistani study found that educating women to at least the primary level was likely to be three times more effective than increasing household income by 10%. It is argued that reducing women's time and energy in domestic chores would free up time for adequate child care and nutrition. Women in Benue State reduced their water-fetching time by using a wheeled water carrier. Cooperatives that mill flour save individual member's milling time. Combining tasks, such as fetching firewood on the way home from the fields, is another time saver.
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PMID:Caring capacity in the management of the nutrition crisis in infants, young children and women in Nigeria. 873 75

Vitamin A deficiency (VAD) and iron deficiency anemia (IDA) have been recognized as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micronutrient Survey on 1678 children 12-71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14% of the children were subclinically vitamin A deficient (plasma retinol < 20 micrograms/dL) and 32% were at risk of VAD (plasma retinol 20-30 micrograms/dL). These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12-23 months old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared with other children. That same doubled risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50% of those mandated by Honduran law. There appears to be significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33% of samples contained no retinol. Overall, 30% of children were anemic (Hb < 11 g/dL). Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33% greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51% and 21%, respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it.
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PMID:Vitamin A deficiency and anemia among children 12-71 months old in Honduras. 1044 13

This cross-sectional survey, conducted in a periurban health center in Nairobi, Kenya, determined the prevalence of iron deficiency anemia (IDA) and its risk factors among 403 children aged 6 months to 6 years. Demographic data were obtained and each child was assessed for signs of IDA. Blood was drawn for hemoglobin determination. The diagnosis of IDA was made using predefined criteria. Findings revealed that the prevalence of IDA was 7.4% (95% confidence interval = 4.8-10.0) and was predominantly mild (93.6%). Age was found to be significantly associated with IDA, with a 14.6% prevalence rate in infants. No association was found between IDA and factors such as sex, birth weight, weaning age and weaning diet, sanitation, water source, or education of the mother. Although the study showed that IDA was not a major health problem in the area, as evidenced by the low prevalence rate and presence of only mild cases, there is still a need for emphasis on health education at the health facility since young children are at high risk of IDA.
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PMID:Iron deficiency anaemia in children of a peri-urban health facility. 1068 24

The world balance of population and resources is the internationally accepted goal for the 20th century. There is agreement that the requirements are elimination of absolute poverty, the legitimate satisfaction of the majority population, reduction in the environmental cost of development, fairer distribution of the benefits of development, slower population growth, and more balanced distribution within and between countries. A profile is given for 15 development and population measures for the Philippines. In the Philippines over 50% of the population lives in poverty, and the numbers are increasing. Unemployment is high at 10.6% in 1991, and underemployment is estimated to be 31.6%. Limited employment opportunities are push factors for international labor migration, which has swelled to over 600,000 workers. The Philippines is losing forest at the rate of about 119,000 hectares per year, which would result in a total loss of forests in 12 years. The loss of biodiversity is apparent. Marine resources are being depleted, and average farm size per rural person is 0.38 hectares. The average family of 6 persons must produce food on only 2.28 hectares. The annual population growth rate is 2.3%, and the rate of food production is only 1%. Metro Manila is now the 18th largest urban area in the world. Air pollution is very high, and the water supply is polluted with salt. 14% of children under 6 years old are severely underweight. Iron deficiency anemia affects 60% of children 1-6 years old and 40% of children 7-12 years old. 3.5 million children are working, and 20,000 are child prostitutes. 85,000 street children live in 17 cities. Maternal mortality is estimated at 1600 women each year, and 24% of deaths in 78 hospitals were due to induced abortion. About 2.7 million women have unmet need for family planning, and 1.8 million desire family planning but are not using any method.
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PMID:Sustaining a world in balance. 1217 36

Toxicity studies were performed with a chemically defined mixture of 25 groundwater contaminants, using dose levels considered to have environmental relevance. The mixture contained 19 organic compounds and six metals (shown below); the selection of these compounds was based primarily on the frequency of their occurrence in United States Environmental Protection Agency surveys of groundwater contamination in the vicinity of hazardous waste disposal sites. This report focuses primarily on 26-week drinking water toxicity studies with male and female F344/N rats and B6C3F(1) mice. The endpoints evaluated included histopathology, clinical pathology, neurobehavioral studies, and reproductive toxicity. Additional studies using this same chemical mixture are briefly reviewed in this report and include an evaluation of spermatogenesis in B6C3F(1) mice exposed to the chemical mixture for 13 weeks, a continuous breeding study with Sprague-Dawley rats and CD-1(R) Swiss mice, studies of myelotoxicity in B6C3F(1) mice exposed to the chemical mixture for up to 31.5 weeks, studies of immunosuppression in B6C3F(1) mice exposed for up to 13 weeks, in vitro mutagenicity assays in Salmonella typhimurium and Escherichia coli, and measures of genetic damage in bone marrow and peripheral blood of F344/N rats and B6C3F(1) mice in 2-week drinking water studies. In a 26-week drinking water study in which rats were administered the chemical mixture at composite contaminant concentrations of 0, 11, 38, 113, or 378 ppm, no deaths occurred and the body weight gain of high-dose males was slightly less than that of the controls. Water consumption decreased with dose and was 24% to 28% less than that of the controls at the highest concentration. Changes in organ weights occurred primarily in high-dose rats and included increased absolute and relative liver and kidney weights in females, increased relative kidney weight in males, and decreased absolute and relative thymus weights in males and females. Hematologic assessments indicated that rats receiving 378 ppm developed a microcytic anemia consistent with that accompanying iron depletion. Multiple foci of inflammation occurred in the liver of exposed rats. In high-dose females, these liver lesions were especially prominent and included bile duct and oval cell hyperplasia. Inflammation also occurred in the mesenteric lymph nodes, the adrenal gland, and the spleen. The amount of hemosiderin in the spleens of rats receiving the higher concentrations of the chemical mixture was less than normal. Components of a chemical mixture of 25 groundwater contaminants include acetone, aroclor 1260, arsenic, benzene, cadmium, carbon tetrachloride, chlorobenzene, chloroform, chromium, 1,1-dichloroethane, 1,2-dichloroethane, 1,1-dichloroethylene, 1,2-trans-dichloroethylene, di(2-ethylhexyl) phthalate, ethylbenzene, lead, mercury, methylene chloride, nickel, phenol, tetrachloroethylene, toluene, 1,1,1-trichloroethane, trichloroethylene, xylenes. In a 26-week study in which mice were exposed to the chemical mixture at concentrations of 0, 11, 38, 113, and 378 ppm in drinking water, there were no clear adverse effects noted in survival, weight gain, clinical pathology parameters, or histopathologic evaluations. Water consumption decreased with increasing dose, and water consumption by high-dose mice was approximately 40% less than that by the controls. In neurobehavioral assessments, no clear treatment-related effects were observed in measures of forelimb and hindlimb grip strength, hindlimb footsplay, motor activity, response to a thermal stimulus, or startle response in rats or mice evaluated at 6-week intervals throughout the 26- week drinking water studies. There were no effects on sperm morphology or motility or on estrous cycle length in rats or mice receiving the chemical mixture during the 26-week studies. Sperm concentration was decreased in F(1) CD-1(R) Swiss mice during continuous breeding studies, although there were no clear adverse effects on the fertility of Sprague-Dawley rats or CD-1(R) Swiss mice in th CD-1® Swiss mice in these studies. Pup weight, the number of live males, and the number of male pups per litter were slightly decreased in dosed rats in the continuous breeding study in rats; the number of live female mouse pups in litters born of the F(0) and F(1) generations was decreased in the 378 ppm group. The significance of these observations, if any, is not known. F(1) mice receiving 378 ppm had increased incidences of hepatic inflammation compared to the controls. In female B6C3F(1) mice that received the chemical mixture in drinking water at concentrations as high as 756 ppm for 2 weeks or 378 ppm for 13 weeks, assessments of immune function showed suppression of hematopoietic stem cells and antigen-induced antibody-forming cells. This was manifested by impaired resistance to challenge with a nonlethal strain of mouse malaria, Plasmodium yoelii. Additional evidence of an adverse effect on hematopoietic stem cells was demonstrated by decreases in the in vitro colony-forming ability of granulocyte-macrophage progenitor cells and erythroid precursor cells isolated from female mice that had received the chemical mixture at a concentration of 378 or 756 ppm in 31.5 week studies. Potential genotoxic effects of the chemical mixture to the bone marrow of F344/N rats and B6C3F(1) mice were assessed in 2-week drinking water studies with concentrations as high as 756 ppm. Small increases in sister chromatid exchanges and micronucleated polychromatic erythrocytes occurred in the bone marrow of dosed male mice, and micronucleated polychromatic erythrocytes were also increased in dosed female mice. The chemical mixture did not induce mutations in Salmonella typhimurium strains TA98 and TA100 and did not induce DNA damage in Escherichia coli with or without metabolic activation. In summary, rats receiving drinking water containing a mixture of 25 common groundwater contaminants at levels of potential environmental relevance developed inflammatory lesions in the liver, spleen, lymph nodes, and adrenal gland, as well as evidence of an iron deficiency anemia. The inflammatory lesions could not be predicted based on the known toxic effects of the individual components of the chemical mixture. Mice exposed to similar concentrations of the chemical mixture did not show adverse effects in a standard toxicity study but developed deficits in bone marrow function, evidence of genetic damage, hepatic inflammation, and immunosuppression in other studies that generally included exposures to higher concentrations or exposures of longer duration. A no-observed-adverse-effect level for histologic injury (granulomatous inflammation of the liver) was 11 ppm in rats; however, no clear evidence for histologic injury was seen in mice exposed to concentrations of the chemical mixture as high as 378 ppm in a standard 26-week study. NOTE: These studies were supported in part by funds from the Comprehensive Environmental Response, Compensation, and Liability Act trust fund (Superfund) by an interagency agreement with the Agency for Toxic Substances and Disease Registry, U.S. Public Health Service.
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PMID:NTP technical report on the toxicity studies of a Chemical Mixture of 25 Groundwater Contaminants Administered in Drinking Water to F344/N Rats and B6C3F(1) Mice. 1220 89

Inflammatory bowel disease is often associated with iron deficiency anemia and oral iron supplementation may be required. However, iron may increase oxidative stress through the Fenton reaction and thus exacerbate the disease. This study was designed to determine in rats with dextran sulfate sodium (DSS)-induced colitis whether oral iron supplementation increases intestinal inflammation and oxidative stress and whether the addition of an antioxidant, vitamin E, would reduce this detrimental effect. Four groups of rats that consumed 50 g/L DSS in drinking water were studied for 7 d and were fed: a control, nonpurified diet (iron, 270 mg, and dl-alpha-tocopherol acetate, 49 mg/kg); diet + iron (iron, 3000 mg/kg); diet + vitamin E (dl-alpha-tocopherol acetate, 2000 mg/kg) and the diet + both iron and vitamin E, each at the same concentrations as above. Body weight change, rectal bleeding, histological scores, plasma and colonic lipid peroxides (LPO), plasma 8-isoprostane, colonic glutathione peroxidase (GPx) and plasma vitamin E were measured. Iron supplementation increased disease activity as demonstrated by higher histological scores and heavier rectal bleeding. This was associated with an increase in colonic and plasma LPO and plasma 8-isoprostane as well as a decrease in colonic GPx. Vitamin E supplementation decreased colonic inflammation and rectal bleeding but did not affect oxidative stress, suggesting another mechanism for reducing inflammation. In conclusion, oral iron supplementation resulted in an increase in disease activity in this model of colitis. This detrimental effect on disease activity was reduced by vitamin E. Therefore, the addition of vitamin E to oral iron supplementation may be beneficial.
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PMID:Iron supplementation increases disease activity and vitamin E ameliorates the effect in rats with dextran sulfate sodium-induced colitis. 1236 9

The authors report a new case of water-melon stomach, without portal hypertension, and responsible for a iron deficiency anemia cured by antrectomy. Water-melon stomach is a particular form of gastric antral vascular ectasia, characterized by a specific and striking endoscopic aspect. The diagnostic, histologic, pathogenic and therapeutic aspects are reviewed.
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PMID:[Watermelon stomach: a rare cause of iron deficiency anemia, surgically treatable; a new case with review of the literature]. 1455 97

Pica, the compulsive ingestion of non-food substances, is a common, yet less well known symptom of iron deficiency anemia (IDA). Ice eating or pagophagia is one of the most common forms of pica associated with iron deficiency and IDA, and has only recently been identified among patients who had undergone Roux-en-Y gastric bypass (RYGBP). This article presents additional cases of pagophagia in women which emerged after RYGBP and resolved with iron treatment. These cases, added to the literature, lead to further discussion of how healthcare providers can subtly probe patients for the presence of pica.
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PMID:Emergence of pica (ingestion of non-food substances) accompanying iron deficiency anemia after gastric bypass surgery. 1635 33

People who live in food and water deficit regions of Sahelien West Africa employ various coping strategies as they attempt to meet their food and water needs. In this paper we discuss various coping strategies employed by rural Nigeriens living in the Tanout and Mirriya administrative regions of central Niger. In rural Niger people often harvest or buy wild plant foods to eat. Laboratory studies of the nutritional content of these plants indicate that there are benefits to eating wild plant foods. In this study we summarize the results of field research conducted during the summer of 2002 on the use of wild plant foods in three regions of rural central Niger. Comparing local use of various wild plant foods with major nutrition-related health problems including protein deficiency, essential fatty acid deficiency, iron deficiency and iron deficiency anemia, calcium deficiency rickets, and zinc deficiency, suggests potential recommendations for consumption of these plants. However, further research on the bioavailability of these nutrients is needed to confirm the potential benefits of these plants.
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PMID:Coping strategies and nutritional health in rural Niger: recommendations for consumption of wild plant foods in the Sahel. 1713 22

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