The prevalance of iron deficieny anemia in Manisa and using of hemogram, RDW and ferritin for searcing of iron deficiency anemia

XI.SUMMARYThe Prevalance Of Iron Deficieny Anemia In Manisa And Using Of Hemogram,RDW and Ferritin For Searcing Of Iron Deficiency AnemiaVildan ÜRK TAŞYENEN, MDIron deficiency anemia is one of the commen health problems duringchildhood. This study was planned to estimate the prevalance of the iron deficiencyanemia in schoolage children and to evaluate the results of hemogram, RDW andferritin levels for diagnosing iron deficiency anemia.Children between 7-11 years of age living in Manisa were selected for thisstudy. Students going to 1st-5th classas of primary school during 2004-2005 weresupposed as study population. 848 of them, 437 boys and 411 girls, were selectedrandomly. Formal permission was taken from The Ministry of Education, schoolmanagers and all families. A questionnaire related with sociodemographic propertieswas applied, anthropometric measurements were done and school performance ofchildren was evaluated by their teacher. Blood for hemogram, ferritin serum iron andiron binding capacity was taken from all children by children nurses with supervisionof pediatrist. Serum samples were studied at Celal Bayar University.Results were statistically analyzed by student t test, pearson correlationanalysis, anova variation analysis and chi square test. Results were accepted assignificant when the p value lower than 0,05.Sociodemographic properties of children; 57% fathers were educated fromprimary school, 4,9% were not literate, 59,6% mothers were educated from primaryschool, 16,3% were not literate. 84,1% mothers were house wife. 40,8% of familieswere living as 4 person at their home. When their nutritional status were evaluated,most of them pay attention to their meals and 76,1% have eaten red meat for 1-2days of week minimally. The lenght and weight persentile of children were between25-75p in 51,4% and 46,7% respectively.Mean values of hemoglobin, hematocrit and ferritin was 12,7±0,7g/dl, 38±2,7%and 32,9±21,7 ng/ml respectively. These results were not different significantlybetween boys and girls except MCV and SIBC that were higher in girls (p<0,04).Ferritin was lower in children whose mother educated from primary school or notliterate according to others. Children of fathers that were not working had lower Hb,Hct but higher RDW values according to fathers that were tradesman. Children whohad 2 sisters or brothers had higher Hct and RBC but lower ferritin levels thanchildren with 4 or more sisters or brothers. Children living as 2-4 person at homehad higher SIBC and lower ferritin levels according to others living with 5 or moreperson. Serum Fe, Hb and Hct levels were lower in children with weight persentile <3than children with 76-97 p but the difference was not significant statistically. Lengthpersentile was not related with hematological parameters.Iron deficiency anemia was diagnosed if Hb was lower than -2 SD according tosex and age (for this age group Hb<11g/dl) and ferritin<20ng/ml. With this criteria 12of 848 children were selected and the prevalance of IDA for this age group wasdetected as 1,4%. There was no any association detected between IDA andsociodemographic properties. Ferritin < 20ng/ml was accepted as iron deficiency.According to this criteria 199 (%24.7) children had iron deficiency.Diagnosing of IDA with rutin hemogram parameters had sensitivity andspesificity of %91.7 and %98.0, positive predictive value and negative predictivevalue of these parameters were %40.7 and 99.9 respectivly. When only RDW wastaken these values were lower. Consequently, if rutin hemogram and high RDWvalues were used as screening tests for detection of IDA, the results were not reflectreality. So rutin hemogram and serum ferritin levels must be evaluated together.Key words: Iron deficiency anemia, prevalance, children.Advisor: Ali ONAG, Prof. Celal Bayar University, Medical Faculty.