Iron-Deficiency Anemia Related to Ancylostoma duodenale Infection in 67 Years Old Female Patient

Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations. Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.

Changes of Serum Ferritin, Hemoglobin, and Serum Iron (SI) and Treatment Effect of Iron Proteinsuccinylate Oral Solution Combined with Vitamin A and D Drops on Children with Nutritional Iron Deficiency Anemia

Objective. The purpose was to evaluate the treatment effect of iron proteinsuccinylate oral solution combined with vitamin A and D drops on children with nutritional iron deficiency anemia. Methods. 124 children treated in the outpatient department of our hospital from January 2017 to January 2020 were selected as the study subjects. They were randomly divided into control and observation two groups. The control group was treated with iron proteinsuccinylate oral solution (1.5 mL/kg) in the morning and evening, respectively. The observation group received adjuvant treatment with oral vitamin A and D drops based on the treatment of the control group. The treatment effect of proteinsuccinylate oral solution combined with vitamin A and D drops was evaluated by the serum iron (SI), serum ferritin (SF), and transferrin (TRF) levels, the values of CD3+, CD4+, and CD4+/CD8+, and other evaluation indicators. Results. After treatment, the SI and SF levels of children in both groups significantly increased ( P < 0.01 ) while the TRF level significantly decreased ( P < 0.01 ), and the SI and SF levels in the observation group increased more significantly, and the TRF level decreased more significantly compared with those in the control group ( P < 0.01 ). After treatment, the values of CD3+, CD4+, and CD4+/CD8+ of children in both groups significantly increased compared with those before treatment ( P < 0.01 ), and the values of CD3+, CD4+, and CD4+/CD8+ increased more significantly in the observation group compared with those in the control group ( P < 0.01 ). In addition, the evaluation results of treatment effect showed that the markedly effective rate in the observation group was significantly higher than that in the control group ( P < 0.01 ). Conclusion. Iron proteinsuccinylate oral solution combined with vitamin A and D drops can better improve the anemia symptoms in children, with high application value.

A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia

Iron deficiency anemia (IDA) has a long-term impact on each life stage and remains worldwide a major public health problem. Eleven experts were invited to participate in a virtual meeting to discuss the present situation and the available intervention to prevent iron deficiency anemia in Indonesia. The experts consisted of obstetric gynecologists, pediatricians, nutritionists, midwives, a clinical psychologist, and an education expert. Existing interventions focus attention on preconception and early childhood stages. Considering the inter-generational effects of IDA, we call attention to expanding strategies to all life stages through integrating political, educational, and nutritional interventions. The experts agreed that health education and nutritional intervention should be started since adolescence. Further research to explore the effectiveness of these interventions would be important for many regions in the world. The outcome of this Indonesian consensus is applicable worldwide.

Efficacy and safety of ferric derisomaltose (FDI) compared with iron sucrose (IS) in patients with iron deficiency anemia after bariatric surgery

Purpose Iron deficiency is common following bariatric surgery, and treatment with intravenous iron is often required. This post hoc analysis of data from two randomized, open-label, multicenter trials evaluated the efficacy and safety of ferric derisomaltose (FDI; formerly iron isomaltoside 1000) versus iron sucrose (IS) over 4 weeks in adults with iron deficiency anemia (IDA) resulting from prior bariatric surgery. Materials and methods Data were pooled for participants who received FDI or IS in the PROVIDE or FERWON-IDA trials for the treatment of IDA post bariatric surgery. Efficacy outcomes included changes in hemoglobin (Hb) and iron parameters; safety outcomes included the incidence of adverse drug reactions (ADRs), serious or severe hypersensitivity reactions (HSRs), and hypophosphatemia. Results The analysis included 159 patients. Mean (standard deviation) cumulative iron doses were 1199 (± 347) mg for FDI and 937 (± 209) mg for IS. Compared with IS, FDI resulted in a faster and more pronounced Hb response, and a higher proportion of responders (Hb level increase ≥ 2 g/dL from baseline) at all time points. The incidence of ADRs was similar with FDI and IS (15.1% and 18.2%, respectively), with no serious ADRs or serious or severe HSRs reported. The incidence of hypophosphatemia was low and similar in both treatment groups, with no cases of severe hypophosphatemia observed. Conclusions In patients with IDA resulting from bariatric surgery, FDI produced a faster and more pronounced Hb response than IS. Both FDI and IS were well tolerated. Graphical abstract

Examination of Haemoglobin (HB) Levels of Young Women and Counseling on Iron Deficiency Anemia in Young Women and Administration of Fe Tablets

The problem of iron deficiency is a common problem in developing countries, Indonesia being one of them. One of the targets for increasing iron is young women because it influences growth and development to become pregnant women. The purpose of this community service activity is to check hemoglobin levels and focus on increasing young women's understanding of the situation of iron deficiency anemia during the Covid 19 Pandemic. So that after sense emerges, it is hoped that they will be able to implement awareness to consume Fe tablets. The method used is to provide health education in the form of interactive lectures and check hemoglobin levels. The target of the implementation of this activity is all 20 students of SMP Terpadu Ishlahul Mubtadiin Cihaurbeuti Ciamis grades 7, 8, and 9. The results of laboratory examinations, most of the students did not experience anemia as much as 65%, but there were 35% of students who had anemia, either mild (20%), moderate (10%), and severe (5%). The results of the examination laboratories most big girls do not experience anemia as much as 65%, but there are 35% of students experiencing anemia both mild (20%), moderate (10 %), and weight (5%). Activity devotion people have managed to achieve the purpose of its implementation, namely the increase in understanding adolescent daughter against situation anemia, with the discovery of cases of anemia in target further increase the awareness of the target, especially teenage daughter in changing patterns of life, especially eating food that is nutritious as well pattern rest of the teenagers are.

Edukasi Anemia Defisiensi Besi dan Pemeriksaan Hemoglobin sebagai Deteksi Dini Resiko pada Ibu Hamil di Desa Matang Seulimeng Kecamatan Langsa Barat Kota Langsa

ABSTRAK Anemia merupakan masalah global terutama bagi ibu hamil. Penyebab utama anemia pada kehamilan adalah defisiensi besi kemudian diikuti oleh defisiensi folat. WHO memperkirakan angka kejadian anemia sekitar 42 % terjadi pada ibu hamil dengan kondisi ekonomi menengah kebawah. Tujuan Pengabdian ini adalah untuk meningkatkan pengetahuan ibu hamil. tentang anemia defisensi besi dan pemeriksaan kadar hemoglobin sebagai deteksi dini mandiri di Desa Matang Seulimeng wilayah kerja Puskesmas Langsa Barat Kota Langsa. Bentuk kegiatan pengabdian masyarakat adalah dengan metode penyuluhan dengan ceramah dan tanya jawab. Sedangkan deteksi dini resiko tinggi dilakukan dengan pemeriksaan kadar hemoglobin dan setelah 2 minggu intervensi dilakukan evaluasi ibu hamil anemia dengan pemeriksaan kadar Hemoglobin. Terjadi perubahan peningkatan pengetahuan baik sebesar 85 % dan hasil pemeriksaan hemoglobin dari 18 ibu hamil anemia setelah evaluasi menjadi 67,8 % tidak anemia .Penilaian mengenai pemahaman ibu hamil tentang edukasi anemia Defisiensi besi dan pemeriksaan Hemoglobin sebagai deteksi dini resiko pada ibu hamil adalah 3 (tiga) tahap (tahap pretest, tahap penyuluhan, dan tahap posttest serta evaluasi ibu hamil anemia). Adanya peningkatan pengetahuan setelah diberikan edukasi anemia defisiensi pada ibu hamil, dan mampu melakukan deteksi dini mandiri tanda gejala anemia sehingga mendapat penanganan sesegera mungkin. Kata Kunci : anemia defisiensi zat besi, kadar hemoglobin, deteksi dini, ibu hamil ABSTRACT Anemia is a global problem, especially for pregnant women. The main cause of anemia in pregnancy is iron deficiency followed by folate deficiency. WHO estimates that the incidence of anemia is around 42% in pregnant women with middle to lower economic conditions. The purpose of this service is to increase the knowledge of pregnant women. regarding iron deficiency anemia and hemoglobin level examination as an independent early detection in Matang Seulimeng Village, the working area of Langsa Barat Health Center, Langsa City. The form of community service activities is the extension method with lectures and questions and answers. Meanwhile, early detection of high risk is carried out by examining hemoglobin levels and after 2 weeks of intervention, pregnant women with anemia are evaluated by examining hemoglobin levels. There was an increase in knowledge of both 85% and the results of hemoglobin examination from 18 anemic pregnant women after the evaluation became 67.8% not anemic. An assessment of the understanding of pregnant women about iron deficiency anemia education and hemoglobin examination as early detection of risk in pregnant women is 3 (three) stages (pretest stage, counseling stage, and posttest stage and evaluation of anemic pregnant women). There is an increase in knowledge after being given education on deficiency anemia in pregnant women, and being able to independently detect early signs of anemia so that they get treatment as soon as possible. Keywords: iron deficiency anemia, hemoglobin levels, early detection, pregnant women