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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship of anemia as a risk factor for maternal mortality was analyzed by using cross-sectional, longitudinal and case-control studies because randomized trials were not available for analysis. The following six methods of estimation of mortality risk were adopted: 1) the correlation of maternal mortality rates with maternal anemia prevalence derived from national statistics; 2) the proportion of maternal deaths attributable to anemia; 3) the proportion of anemic women who die; 4) population-attributable risk of maternal mortality due to anemia; 5) adolescence as a risk factor for anemia-related mortality; and 6) causes of anemia associated with maternal mortality. The average estimates for all-cause anemia attributable mortality (both direct and indirect) were 6.37, 7.26 and 3.0% for Africa, Asia and Latin America, respectively. Case fatality rates, mainly for hospital studies, varied from <1% to >50%. The relative risk of mortality associated with moderate anemia (hemoglobin 40-80 g/L) was 1.35 [95% confidence interval (CI): 0.92-2.00] and for severe anemia (<47 g/L) was 3.51 (95% CI: 2.05-6.00). Population-attributable risk estimates can be defended on the basis of the strong association between severe anemia and maternal mortality but not for mild or moderate anemia. In holoendemic malarious areas with a 5% severe anemia prevalence (hemoglobin <70 g/L), it was estimated that in primigravidae, there would be 9 severe-malaria anemia-related deaths and 41 nonmalarial anemia-related deaths (mostly nutritional) per 100,000 live births. The iron deficiency component of these is unknown.
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PMID:An analysis of anemia and pregnancy-related maternal mortality. 1116 May 93

The continuing unresolved debate over the interaction of iron and infection indicates a need for quantitative review of clinical morbidity outcomes. Iron deficiency is associated with reversible abnormalities of immune function, but it is difficult to demonstrate the severity and relevance of these in observational studies. Iron treatment has been associated with acute exacerbations of infection, in particular, malaria. Oral iron has been associated with increased rates of clinical malaria (5 of 9 studies) and increased morbidity from other infectious disease (4 of 8 studies). In most instances, therapeutic doses of oral iron were used. No studies in malarial regions showed benefits. Knowledge of local prevalence of causes of anemia including iron deficiency, seasonal malarial endemicity, protective hemoglobinopathies and age-specific immunity is essential in planning interventions. A balance must be struck in dose of oral iron and the timing of intervention with respect to age and malaria transmission. Antimalarial intervention is important. No studies of oral iron supplementation clearly show deleterious effects in nonmalarious areas. Milk fortification reduced morbidity due to respiratory disease in two very early studies in nonmalarious regions, but this was not confirmed in three later fortification studies, and better morbidity rates could be achieved by breast-feeding alone. One study in a nonmalarious area of Indonesia showed reduced infectious outcome after oral iron supplementation of anemic schoolchildren. No systematic studies report oral iron supplementation and infectious morbidity in breast-fed infants in nonmalarious regions.
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PMID:Iron and its relation to immunity and infectious disease. 1116 May 94

Malaria's pyrogenic threshold seems to depend on factors such as age and transmission patterns. We studied the temperature at admission of 200 patients with mild malaria and observed that after adjusting for body mass index, the presence of other helminths, and other confounders, only hookworm-infected patients had lower fever at admission that those without hookworm infection (37.5 +/- 0.9 and 38 +/- 0.8, respectively; P < 0.001). Thus, we suggest the age dependence of the pyrogenic threshold could have been confounded by the epidemiology of iron deficiency.
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PMID:Short report: Hookworm infection is associated with decreased body temperature during mild Plasmodium falciparum malaria. 1150 88

The diagnosis of iron deficiency anemia in malaria endemic areas is complicated by the influence of the infection on the laboratory tests conventionally used to assess iron status. Determination of soluble transferrin receptor (sTfR) levels has been shown to be a sensitive indicator of iron deficiency in adults and is not affected by a range of infectious and inflammatory conditions. The utility of sTfR levels in the diagnosis of iron deficiency in malaria endemic areas remains unresolved. Three hundred and fourteen infants in a rural area of southern Tanzania living under conditions of intense and perennial malaria transmission were studied to determine the utility of sTfR plasma levels in the assessment of iron deficiency anemia. Independent of the presence of anemia, malaria parasitemia was associated with a significant increase in sTfR plasma levels that were even higher than those found in iron deficiency anemia. We conclude that the measurement of sTfR levels does not have a role in the diagnosis of iron deficiency anemia in young children exposed to malaria infection.
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PMID:Effect of malaria on soluble transferrin receptor levels in Tanzanian infants. 1150 89

This article investigates: (1) the criteria used to select cohorts of patients for study when seeking genetic causes of "osteoporosis;" (2) the possibilities, genetic and otherwise, that might cause or help to cause this disorder; and (3) how one should define this disorder and bone health. Patients selected for such a study because current World Health Organization (WHO) absorptiometric criteria diagnosed them with "osteoporosis," or because they had extremity bone fractures, could possibly include people with biologically different disorders, in addition to those with healthy or diseased bones. Seeking a common genetic cause of "osteoporosis" in such inhomogeneous cohorts may be like seeking a common genetic cause of "anemia" in a cohort that contained iron deficiency and pernicious anemias, thalassemia, sickle-cell disease, anemias due to blood loss, malnutrition, malaria, metastatic disease, etc. The Utah paradigm's insights suggest how to select more homogeneous cohorts for such studies. This would require defining bone health in a way that acknowledges the main purpose of load-bearing bones, which the WHO criteria do not do. The present understanding of bone physiology indicates that many biologic mechanisms and features could cause or help to cause an osteopenia or osteoporosis. This study identifies 30 such mechanisms, some osseous and some extraosseous, and even this number seems conservative. Because each such mechanism could depend on any number of genes, when a strong genetic association with some kind of osteopenia or osteoporosis is found it could be difficult to determine which mechanism(s) it perturbed. This article summarizes the evidence and ideas on which these suggestions depend.
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PMID:Seeking genetic causes of "osteoporosis:" insights of the Utah paradigm of skeletal physiology. 1170 89

There is a significant increase in cases of malaria in Italy. The incidence among Italian citizens has remained quite stable since 1990, while the number of cases among foreigners residing in Italy has continued to increase. The clinical manifestations of plasmodium infection can be less evident in these people: they often have only mild complaints for weeks or months. The case of a Senegalese woman with Plasmodium malariae infection is presented. She had been in Italy for 13 months and was 4-month pregnant. Her only symptoms were asthenia and microcytic anemia; she was afebrile. Her anemia was initially believed to be due to iron deficiency: she was treated with iron and folic acid. The anemia worsened, and resolved only after antimalarial therapy with chloroquine.
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PMID:[Unusual case of malaria in Italy]. 1179 27

Anaemia in pregnancy is associated with maternal morbidity and mortality and is a risk factor for low birth-weight. Of 507 pregnant women recruited in a community, cross-sectional study in southern Tanzania, 11% were severely anaemic (<8 g haemoglobin/dl). High malarial parasitaemia [odds ratio (OR)=2.3] and iron deficiency (OR=2.4) were independent determinants of anaemia. Never having been married (OR=2.9) was the most important socio-economic predictor of severe anaemia. A subject recruited in the late dry season was six times more likely to be severely anaemic than a subject recruited in the early dry season. Compared with the women who were not identified as severely anaemic, the women with severe anaemia were more likely to present at mother-and-child-health (MCH) clinics early in the pregnancy, to seek medical attention beyond the MCH clinics, and to report concerns about their own health. Pregnancy-related food taboos in the study area principally restrict the consumption of fish and meat. Effective anti-malaria and iron-supplementation interventions are available but are not currently in place; improvements in the mechanisms for the delivery of such interventions are urgently required. Additionally, opportunities for contacting the target groups beyond the clinic environment need to be developed.
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PMID:Anaemia during pregnancy in southern Tanzania. 1219 8

Maternal anemia is an important cause of maternal mortality and morbidity in developing countries. It is responsible for intrauterine growth retardation, pre-term labor, intrauterine death, and birth of very low-birth-weight infants who die soon after birth, leading to a high perinatal mortality. This article discusses the incidence and prevalence of maternal anemia in developing countries. According to reviews, the highest prevalence rates of maternal anemia in the reproductive age group and pregnant women are found in South Asia and sub-Saharan Africa. In these regions, it is estimated that two-thirds of pregnant women and one-half of the nonpregnant women are anemic. Causes of anemia cited in this article include malaria, which causes destruction of red blood cells; and iron deficiency, which hinders the immune system's ability to fight infection. In the successful management of anemia, reliable techniques for detection, assessing its severity and monitoring the response to appropriate treatment should be available. Moreover, programs such as the National Nutritional Anaemia Prophylaxis Programme, which comprehensively covered the promotion consumption of iron and folate supplements, are much needed.
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PMID:Anaemia -- the scourge of the Third World. 1234 64

Children are especially liable to iron-deficiency anaemia in developing countries, and in the inner cities of developed countries. Does the lack of iron cause impaired physical and mental development, and can this in certain circumstances be a permanent effect? One of the reasons that this is such a difficult question to answer is that there can be so many confounding factors, from other nutritional deficiencies, to helminthic infections and malaria in tropical countries. If there is a definite relationship, children in the first 2 years of life will be at particular risk during the mayor spurt of brain growth. Lack of iron can affect brain cells, myelin, or neurotransmitters, so there is certainly a theoretical basis for possible brain damage, or there could be an effect from lack of oxygen. Also anaemic children are likely to feel ill and unwilling to co-operate with tests to assess for developmental defects. Many studies of the possible results of iron deficiency on the development of children have been carried out in various countries, and some of these from 1983 onwards are recorded. It is difficult to draw conclusions from these trials, partly due to the variability in their construction, but on balance the evidence suggests that treatment of iron deficiency is justifiable, whether this is associated with anaemia or not. It is equally important to stress the importance of prevention, although more research is needed on the best method to use, which is both effective and affordable.
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PMID:Iron deficiency and the intellect. 1253 26

Iron deficiency is the most common nutritional disorder in the world. Pregnant women are at especially high risk for iron deficiency and iron deficiency anemia. A considerable proportion of pregnant women in both developing and industrialized countries become anemic during pregnancy. The prevalence of anemia in pregnant women has remained unacceptably high worldwide despite the fact that routine iron supplementation during pregnancy has been almost universally recommended to prevent maternal anemia, especially in developing countries over the past 30 years. The major problem with iron supplementation during pregnancy is compliance. Despite many studies, the relationship between maternal anemia and adverse pregnancy outcome is unclear. However, there is now sufficient evidence that iron supplements increase hemoglobin and serum ferritin levels during pregnancy and also improve the maternal iron status in the puerperium, even in women who enter pregnancy with adequate iron stores. Recent information also suggests an association between maternal iron status in pregnancy and the iron status of infants postpartum. The necessity of routine iron supplementation during pregnancy has been debated in industrialized countries and routine supplementation is not universally practiced in all these countries. In view of existing data, however, routine iron supplementation during pregnancy seems to be a safe strategy to prevent maternal anemia in developing countries, where traditional diets provide inadequate iron and where malaria and other infections causing increased losses are endemic.
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PMID:Iron supplementation in pregnancy. 1460 Dec 65


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