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1/ 2 :
1- Golder B. Iron deficiency anemia. In Behrman RE, Kilegman RM. Nelson text book of pediatrics: from WB Saunders Company. Philadelphia; USA, 17thed, 2004: 1614-16.
2- Wu AC, Lesperance L, Bernstein H. Screening from iron deficiency. Pediatrics in Review. 2002; 23 (5): 171-77.
3- Mannar MGV. Designing effective programs to prevent and control iron deficiency anemia. J Clin Nutr. 1998; 89 (2): 23-26.
4 -
! 1 /! , ) 23 4 / ' A *' / (1" ' # ' 8 76
- 1375 .
5- Oski FA. Iron deficiency in infancy and childhood. N Engl J Med. 1993; 329: 190-93.
6 -
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A /9
! 1% /B ! 6 / !
>U"
.
$ 1 ) C (' ' > ! ! 0
, $ 1381 . GA G*'
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14 ) 44 :(
73 - 78 .
7- Caballo RN, Garcia P, Valdemoro M, Del Castillo ML, Santos TM, Gonzalez VA, et al. The prevalence of anemia in the children and adolescents of Madrid. An Esp Pediatr. 2000; 52 (5): 495-96.
8- Norton RC, Figueiredo RC, Diamante R, Goluart EM, Mota JA, Viana MB. Prevalence of anemia among school- children from Rio Acima (state of Minas Gerais, Brazil): use of standardized prevalence method and evaluation of iron deficiency. Braz J Med Biol Res. 1996; 29 (12): 1617-24.
9- Halterman JS, Koczorowski JN, ALigne CA, Szilagyi PG. Iron deficiency and cognitive achievement among school aged children and adolescents in the United States. Pediatrics. 2001. 107 (6): 1381-86.
10- Ahmed F, Khan MR, Islam M, Kabir I, Fuchs GJ. Anemia and iron deficiency among adolescent school girls in peri-urban Bangladesh. Eur J Clin Nutr. 2000; 54 (9): 678-83.
11- Needlman R. Assessment of Growth. In Behrman RE, Kilegman RM. Nelson text book of pediatrics. 17th ed. . Philadelphia: WB Saunders; 2004.
12- Stoltzfus RJ, Dreyfuss ML. Guidelines for the use of iron supplements to prevent and treat iron deficiency anaemia .Washington DC, international nutritional anemia consultative group/WHO/UNICEF, 1998.
13- Scott JP. Anemia. In Kliegman RM, Marcdante KJ, Jenson HB, Behrman RE. Nelson essentials of pediatrics. 5th ed. Philadelphia: Elsevier Saunders; 2006.
14- Hashizume M, Kunii O, Sasaki S, Shimoda T, Wakai S, Mashitova Z. Anemia and iron deficiency among school children in the Aral Sea region, Kazakhstan. J Trop Pediatr. 2003; 49 (3): 172-77.
15- Kurniawan YA, Muslimatun S, Achadi EL, Sastroamid JoJo S. Anemia and iron deficiency anemia among young adolescent girls from the peri urban coastal area of Indonesia. Asia Pac Cli Nutr. 2006; 15 (3): 350-56.
16- Foo LH, Khor GL, Tee ES, Dhanaraj P. Determinants of iron status in Malaysian adolescents from a rural community. Int J Food Sci Nutr. 2004; 55 (6): 517-25.
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. 0 /()% " l 54 B GA 8 23 GA G*' /()% " 1 $ " 1 %
1382 i 10:29 - 33 .
19- Abalkhail B, Shawky S. Prevalence of daily breakfast intake, iron deficiency anemia and awareness of being anemic among Saudi school students. Int J Food Sci Nutr. 2002; 53 (6): 519-28.
20- Nead KG, Halterman JS, Kaczorowski JM, Auinger P, Weitzman M. overweight children and adolescents: a risk group for iron deficiency. Pediatrics. 2004; 114: 104-108.
21- Lozoff B, Jimenez E, Wolf AW. Long- term developmental outcome of infants with iron deficiency. N Engl J Med.
1991; 325: 687-94.
Title: Prevalence of iron deficiency and its related anemia in junior school students in Birjand Authors: A. Fesharakiniya1, GhR. Sharifzadeh2, M. Sadrzadeh,3H. Segalahgi3
Abstract
Background and Aim: Iron deficiency is the most common nutritional deficiency in the world and its related anemia is the most common hematological disease in children and adolescents. Since iron deficiency can produce anemia and learning difficulties in children in rapid- growing ages, awareness of its prevalence can affect on planning preventive measures. The present study aimed at determining iron deficiency prevalence , its related anemia, and some relevant factors in junior school students in Birjand in 2006.
Materials and Methods: In this cross- sectionaland descriptive study, 450 students from junior schools were selected by multi-stage random method. After the study was clarified, parents filled out their respective consent forms regarding their children and personal information of the students was recorded; thus, height and weight of students were measured and body mass index (BMI) was calculated. CBC differential and serum ferritin were measured. Iron deficiency was defined as serum ferritin%12µg/L and anemia was defined as Hb<12g/dL and iron deficiency anemia was defined as both (SF%12, Hb<12).The obtained data were analysed by means of SPSS software and statistical tests (Chi-Square and Fisher) at the level of =0.05.
Results: Prevalence of anemia was 3.6%, iron deficiency anemia 1.8% and iron deficiency was 24%.
Prevalence of iron deficiency showed significant relationship to sex (female), menstruation, and increasing age. There was not a significant relationship between iron deficiency and its respective anemia to score, degree of birth, body mass index, age, job, and parents’ level of education.
Conclusion: With regard to relatively high prevalence of iron deficiency and its health and socioeconomic complications, it is recommended that screening programs for iron deficiency will be done during the rapid- growing age of children so that they would be treated if necessary.
Key Words: Iron deficiency; Anemia; BMI; Students; junior school.
1Corresponding author, Assistant Professor, Department of Pediatrics, Faculty of Medicine, Birjand University of Medical Sciences.
Birjand, Iran [email protected]
2Epidemiologist; Instructor, Department of Community Medicine, Faculty of Medicine, Birjand University of Medical Sciences.
Birjand, Iran
3Physician