Iron Deficiency Anemia
Bijeta Nepal
NINE
IRON
Iron is considered to be trace minerals
also plays vital role to perform various
body function.
Function
It helps in formation of hemoglobin and brain
development.
Regulation of body temperature, muscle
activity and catecholamine metabolism.
Lack of iron affects immune system, it
diminish the number of T cells and antibodies.
Iron is also the component of myoglobin,
cytochromes, catalase and certain enzyme
Major function of iron is oxygen transport
and cell respiration.
Sources of Iron
Two forms: Haem-Iron and Non-Haem
iron
Haem iron is better absorbed than
non-haem iron
Haem-Iron: Liver, Meat, Poultry, Fish
Promote the absorption of
non-haem iron in plant foods eaten
at the same time
Non-haem iron: Vegetable origincereals, green leafy vegetables,
Requirement
10-18 mg/ day
70% of iron stored in hemoglobin and
26% is stored in liver, spleen and
bones.
e: Adhikari BK, Koirala U, Lama STA, Dahal P. Situation of Iron Deficiency and Its
ement Prioritizing Dietary Interventions in Nepal. Nepal Journal of Epidemiology.
2(2):182-90
Iron deficiency anemia
It is a condition in which the
hemoglobin content of blood is lower
than what is regarded as normal for
particular age, sex, group due to
deficiency of iron.
The red cells are microcytic,
hypochromic .
A hemoglobin level of 10-11 g/dl is
causing early anemia and below
10g/dl as marked anemia.
Diagnosis of Anemia
Hemoglobin
(g/dl)
Adult males
13
Adult females, nonpregnant
12
Adult females, pregnant
11
Children, 6 months to 6
years
11
Children, 6 to 14 years
12
Early anemia: Hb 10-11 g/dl
Marked anemia: Hb <10 g/dl
Causes
a. Increased blood loss: may be due to
. Excessive menstruation in
reproductive years, repeated
miscarriage.
. Hookworm infestation, peptic ulcer,
hemorroids
. Hematuria, hemophysis
b) Increased requirement
During the growth phase i.e. infancy,
childhood, adolescence
Pregnancy and lactation
c. Inadequate dietary intake
Poor economic condition
Anorexia like in pregnancy, young
female.
d. Decreased absorption
Intestinal malabsorption
Partial or total gastectomy
Signs and symptoms
Pallor at palpebral conjuctiva
Paleness of tongue, inside the lips and
mucus membrane
Tiredness
Breathlessness
Less active
Tachycardia and murmur
Nausea and anorexia
National Context
Iron deficiency common among
women and children
Almost half of the children under 5
years of age are suffering from
anemia (NDHS 2011)
35% of women (15-49 years) are
anemic (NDHS, 2011)
46% of under five years children (6
months to 59 months) and 69% of
children aged 6 months 23 months
Treatment
Prevention
Improve intake of iron
Education on nutrition, health and hygiene with special
focus on consuming adequate iron rich foods throughout
pregnancy and the postpartum period
Personal hygiene
Deworming
Multiple Micronutrient powder (MMNP) supplementation
program: Micronutrient powder (Bal-Vita) containing Iron
given to all children 6 months- 2 years of age.
Currently been implemented in 6 districts of Nepal
Rupandehi, Parsa, Gorkha, Rasuwa, Palpa and Makwanpur.
The plan is to scale up this program to all 75 districts by
2015
Prevention
Since 1998, the MoHP has been providing iron
foliate (IFA) at no cost to pregnant women and
breastfeeding mothers through the network of
government health system as part of antenatal
care (ANC) and postnatal care (PNC) services
Pregnant women are provided with 180 tablets
during antenatal visits and are advised to take one
tablet a day. An additional 45 tablets are provided
after childbirth to cover the post natal period
Dose: 60mg iron+ 400mcg folic acid daily from the
beginning of second trimester in pregnancy till 45
days after delivery (225 days)
Thank You
