Impact of lead intoxication in children with iron deficiency anemia in low- and middle-income countries

Blood ◽  
2013 ◽  
Vol 122 (13) ◽  
pp. 2288-2289 ◽  
Author(s):  
Akshat Jain ◽  
Lawrence C. Wolfe ◽  
Ginee Jain
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Lead Intoxication ◽  
Deficiency Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Control of iron deficiency anemia in low- and middle-income countries

Blood ◽  
2013 ◽  
Vol 121 (14) ◽  
pp. 2607-2617 ◽  
Author(s):  
Sant-Rayn Pasricha ◽  
Hal Drakesmith ◽  
James Black ◽  
David Hipgrave ◽  
Beverley-Ann Biggs
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
World Health ◽  
Scientific Development ◽  
Deficiency Anemia ◽  
Current Evidence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Despite worldwide economic and scientific development, more than a quarter of the world’s population remains anemic, and about half of this burden is a result of iron deficiency anemia (IDA). IDA is most prevalent among preschool children and women. Among women, iron supplementation improves physical and cognitive performance, work productivity, and well-being, and iron during pregnancy improves maternal, neonatal, infant, and even long-term child outcomes. Among children, iron may improve cognitive, psychomotor, and physical development, but the evidence for this is more limited. Strategies to control IDA include daily and intermittent iron supplementation, home fortification with micronutrient powders, fortification of staple foods and condiments, and activities to improve food security and dietary diversity. The safety of routine iron supplementation in settings where infectious diseases, particularly malaria, are endemic remains uncertain. The World Health Organization is revising global guidelines for controlling IDA. Implementation of anemia control programs in developing countries requires careful baseline epidemiologic evaluation, selection of appropriate interventions that suit the population, and ongoing monitoring to ensure safety and effectiveness. This review provides an overview and an approach for the implementation of public health interventions for controlling IDA in low- and middle-income countries, with an emphasis on current evidence-based recommendations.

scholarly journals An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries

2021 ◽  
pp. 17-32
Author(s):  
Randa Alsadig Almahdi ◽  
Sami A. Khalid
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Public Health Problem ◽  
Iron Bioavailability ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Middle Income ◽  
Middle Income Countries ◽  
Insight Into ◽  
Low And Middle Income

Background: Iron deficiency anemia is a public health problem of a sizable proportion in developing countries. Recently, emerging biochemical knowledge coupled with the discovery of Hepcidin have greatly advanced our understanding of iron metabolism and offered a better insight into its associated pathophysiology. This knowledge should be applied to iron-deficiency anemia therapy to avoid subsequent sequelae of tissue damage associated with reactive oxygen radicals that are catalyzed by iron, because current practices do not include these advances in the treatment guidelines. In the light of recent progress, the existing iron therapy program in many healthcare settings is controversial. This necessitates adjusting the magnitude of iron dose with respect to the very limited iron bioavailability, as gauged by Hepcidin. The current study was therefore aimed to incorporate newly emerging biochemical knowledge into the current iron-deficiency anemia treatment practice Methods: Literature relevant to iron-deficiency studies published in English between 1964 and 2020 and available online was covered. Conclusion: Evidently, the existing iron-therapy schedule is both inefficient and toxic. The intricate metabolism of iron should be translated into a more rational iron intervention program with special bias towards low- and middle-income countries requiring a more individualized approach. Key words: iron deficiency anemia, hepcidin, oxidative stress, iron therapy

scholarly journals The Importance of Iron Status for Young Children in Low- and Middle-Income Countries: A Narrative Review

2019 ◽  
Vol 12 (2) ◽  
pp. 59 ◽  
Author(s):  
Andrew E. Armitage ◽  
Diego Moretti
Keyword(s):  
Early Childhood ◽  
Iron Deficiency ◽  
Young Children ◽  
Iron Status ◽  
Tissue Growth ◽  
Narrative Review ◽  
Gastrointestinal Infections ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Early childhood is characterised by high physiological iron demand to support processes including blood volume expansion, brain development and tissue growth. Iron is also required for other essential functions including the generation of effective immune responses. Adequate iron status is therefore a prerequisite for optimal child development, yet nutritional iron deficiency and inflammation-related iron restriction are widespread amongst young children in low- and middle-income countries (LMICs), meaning iron demands are frequently not met. Consequently, therapeutic iron interventions are commonly recommended. However, iron also influences infection pathogenesis: iron deficiency reduces the risk of malaria, while therapeutic iron may increase susceptibility to malaria, respiratory and gastrointestinal infections, besides reshaping the intestinal microbiome. This means caution should be employed in administering iron interventions to young children in LMIC settings with high infection burdens. In this narrative review, we first examine demand and supply of iron during early childhood, in relation to the molecular understanding of systemic iron control. We then evaluate the importance of iron for distinct aspects of physiology and development, particularly focusing on young LMIC children. We finally discuss the implications and potential for interventions aimed at improving iron status whilst minimising infection-related risks in such settings. Optimal iron intervention strategies will likely need to be individually or setting-specifically adapted according to iron deficiency, inflammation status and infection risk, while maximising iron bioavailability and considering the trade-offs between benefits and risks for different aspects of physiology. The effectiveness of alternative approaches not centred around nutritional iron interventions for children should also be thoroughly evaluated: these include direct targeting of common causes of infection/inflammation, and maternal iron administration during pregnancy.

scholarly journals Global look at nutritional and functional iron deficiency in infancy

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 471-477
Author(s):  
Michael B. Zimmermann
Keyword(s):  
Iron Deficiency ◽  
Effective Dosage ◽  
Deficiency Anemia ◽  
Middle Income ◽  
Functional Iron Deficiency ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Pathogenic Escherichia Coli ◽  
Measles Vaccination

Abstract Iron-deficiency anemia (IDA) affects many infants in low- and middle-income countries (LMICs) and may impair cognitive development and adaptive immunity. Effective interventions to improve iron intakes for infants in LMICs are urgently needed. However, absorption of oral iron fortificants and supplements is low, usually <10%, and most of the iron passes into the colon unabsorbed. In randomized controlled trials, provision of iron to infants in LMICs adversely affects their gut microbiome and increases pathogenic Escherichia coli, gut inflammation, and diarrhea. To minimize these detrimental effects of iron, it is important to provide the lowest effective dosage and maximize fractional iron absorption. Prebiotic galacto-oligosaccharides and apo-lactoferrin may prove useful in iron formulations in LMICs because they increase absorption of fortificant iron and at the same time may mitigate the adverse effects of unabsorbed iron on the infant gut. Providing well-absorbed iron early in infancy may improve immune function. Recent data from a Kenyan birth cohort suggest IDA at the time of infant vaccination impairs the response to diphtheria, pertussis, and pneumococcus vaccines. A randomized trial follow-up study reported that providing iron to Kenyan infants at the time of measles vaccination increased antimeasles immunoglobulin G (IgG), seroconversion, and IgG avidity. Because IDA is so common among infants in LMICs and because the vaccine-preventable disease burden is so high, even if IDA only modestly reduces immunogenicity of vaccines, its prevention could have major benefits.

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