American Journal of Medical Sciences and Medicine
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American Journal of Medical Sciences and Medicine. 2019, 7(3), 94-104
DOI: 10.12691/ajmsm-7-3-8
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Prevalence and Determinants of Anaemia among Infants Attending Well-baby Clinic at Primary Health Care Centres, Makkah Al-Mokarramah, January 2018: A Cross Sectional Study

Raghda Sami Hassan H. Alhazmi1,

1Joint Program of Family Medicine, Ministry of Health, Makkah Al-Mokarramah, ZIP Code: 21955/P.O.BOX 2442, Kingdom of Saudi Arabiay

Pub. Date: October 25, 2019

Cite this paper:
Raghda Sami Hassan H. Alhazmi. Prevalence and Determinants of Anaemia among Infants Attending Well-baby Clinic at Primary Health Care Centres, Makkah Al-Mokarramah, January 2018: A Cross Sectional Study. American Journal of Medical Sciences and Medicine. 2019; 7(3):94-104. doi: 10.12691/ajmsm-7-3-8


Background. Anaemia is a global problem that can affect the neurodevelopment and behaviour of infants. A study shows that 52% of infants attending well-baby clinics in Saudi Arabia had iron deficiency anaemia, however limited works are done concerning its prevalence and determinants. Thus, this study aims obtain new helpful information towards anaemia among infants by determining its prevalence and determinants at the primary health care centers (PHCCs) in Makkah Al-Makaramah, KSA. Methods. A cross-sectional study was conducted at Makkah Al-Mokarramah primary healthcare centers (Al-khaldyah and Al-Ka’akyah) in January, 2018. Infants who visited the well-baby clinic for vaccination/routine follow-up were selected through convenience sampling technique. A questionnaire filled out by the researcher through an interview with the mother of infants was utilized for data collection. Results. The prevalence of anaemia among 99 infants was found to be 25.3%. Factors significantly associated with anaemia were determined as maternal educational level, job status, absence of post-partum maternity leave, increasing birth order, fetal history of chronic/acute diseases and hospital admission, congenital and parental haemoglobinopathies, later age of weaning, introducing solid/semisolid foods after age of 9 months, <3% weight growth, exclusive breast feeding (first 6 months), caesarean section, maternal post-partum anaemia, health problems and iron deficiency anaemia (IDA), family history of IDA, attending AlKaakyah PHCC, more number of children (≤5 years), parental smoking, infant food type, infant food not prepared by mothers and irregular intake of essential vaccines. Conclusion. Anaemia is a common problem among infants aged one year in Makkah Al-Mokarramah as it affects almost one-quarter of them. Several predictors for anaemiahave been identified in relation to infants, mothers, nutrition and social aspects. Overall, the results may enhance the anaemia-related knowledge among infants and help the authorities to execute a more effective public health interventions in both regional and nation levels.

prevalence-determined-anemia-infants-well baby-primary health care

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[1]  F. Wang, H. Liu, Y. Wan et al. "Prolonged Exclusive Breastfeeding Duration Is Positively Associated with Risk of Anemia in Infants Aged 12 Months." J Nutr, vol. 146, no. 9, pp. 1707-1713, 2016.
[2]  Z. M. Al Hawsawi, S. A. Al-Rehali, A. M. Mahros et al. "High Prevalence of Iron Deficiency Anemia in Infants Attending a Well-Baby Clinic in Northwestern Saudi Arabia." Saudi Med J, vol. 36, no. 9, pp. 1067-1070, 2015.
[3]  M. A. El-HazmiA. S. Warsy. "The Pattern for Common Anaemia among Saudi Children." J Trop Pediatr, vol. 45, no. 4, pp. 221-225, 1999.
[4]  M. Wang. "Iron Deficiency and Other Types of Anemia in Infants and Children." Am Fam Physician, vol. 93, no. 4, pp. 270-278, 2016.
[5]  I. Al Hifzi, R. K. PejaverI. Qureshi. "Screening for Iron Deficiency Anemia in a Well Baby Clinic." Ann Saudi Med, vol. 16, no. 6, pp. 622-624, 1996.
[6]  Department of Health Republic of South Africa. “Age Definitions”, 2012. Source link: 11?download=844:icd-10-definitions&start=15.
[7]  M. S. Elalfy, A. M. Hamdy, S. S. Maksoud et al. "Pattern of Milk Feeding and Family Size as Risk Factors for Iron Deficiency Anemia among Poor Egyptian Infants 6 to 24 Months Old." Nutr Res, vol. 32, no. 2, pp. 93-99, 2012.
[8]  A. Zainel, S. R. O. Osman, S. M. S. Al-Kohji et al. "Iron Deficiency, Its Epidemiological Features and Feeding Practices among Infants Aged 12 Months in Qatar: A Cross-Sectional Study." BMJ Open, vol. 8, no. 5, pp. e020271, 2018.
[9]  N. Alkhateeb. "Risk Factors Associated with Iron Deficiency among Children Admitted to Paediatric Emergency Unit in Erbil, Iraq." Zanco J Med Sci, vol. 14, pp. 1-8, 2010.
[10]  S. M. MonajemzadehM. R. Zarkesh. “Iron Deficiency Anemia in Infants Aged 12-15 Months in Ahwaz, Iran.” Indian J PatholMicrobiol, vol. 52, no. 2, pp. 182-184, 2009.
[11]  C. Male, L. A. Persson, V. Freeman et al. "Prevalence of Iron Deficiency in 12-Mo-Old Infants from 11 European Areas and Influence of Dietary Factors on Iron Status (Euro-Growth Study)." ActaPaediatr, vol. 90, no. 5, pp. 492-498, 2001.
[12]  K. Xu, C. M. Zhang, L. H. Huang et al. "[Risk Factors for Iron Deficiency Anemia in Infants Aged 6 to 12 Months and Its Effects on Neuropsychological Development]." Zhongguo Dang Dai ErKeZaZhi, vol. 17, no. 8, pp. 830-836, 2015.
[13]  T. Konstantyner, T. C. Roma OliveiraJ. A. de Aguiar Carrazedo Taddei. "Risk Factors for Anemia among Brazilian Infants from the 2006 National Demographic Health Survey." Anemia, vol. 2012, pp. 850681, 2012.
[14]  R. D. Semba, S. de Pee, M. O. Ricks et al. "Diarrhea and Fever as Risk Factors for Anemia among Children under Age Five Living in Urban Slum Areas of Indonesia." Int J Infect Dis, vol. 12, no. 1, pp. 62-70, 2008.
[15]  G. WeissL. T. Goodnough. "Anemia of Chronic Disease." N Engl J Med, vol. 352, no. 10, pp. 1011-1023, 2005.
[16]  J. M. Brotanek, J. Gosz, M. Weitzman et al. “Iron Deficiency in Early Childhood in the United States: Risk Factors and Racial/Ethnic Disparities.” Pediatrics, vol. 120, no. 3, pp. 568-575, 2007.
[17]  J. M. Brotanek, J. Gosz, M. Weitzman et al. “Secular Trends in the Prevalence of Iron Deficiency among Us Toddlers, 1976-2002.” Arch PediatrAdolesc Med, vol. 162, no. 4, pp. 374-381, 2008.
[18]  V. Kakkilaya, A. K. Pramanik, H. Ibrahim et al. “Effect of Placental Transfusion on the Blood Volume and Clinical Outcome of Infants Born by Cesarean Section.” ClinPerinatol, vol. 35, no. 3, pp. 561-570, xi, 2008.
[19]  H. T. Li, L. Trasande, L. P. Zhu et al. “Association of Cesarean Delivery with Anemia in Infants and Children in 2 Large Longitudinal Chinese Birth Cohorts.” Am J ClinNutr, vol. 101, no. 3, pp. 523-529, 2015.
[20]  Y. B. Zhou, H. T. Li, L. P. Zhu et al. “Impact of Cesarean Section on Placental Transfusion and Iron-Related Hematological Indices in Term Neonates: A Systematic Review and Meta-Analysis.” Placenta, vol. 35, no. 1, pp. 1-8, 2014.
[21]  R. Gangopadhyay, M. KaroshiL. Keith. “Anemia and Pregnancy: A Link to Maternal Chronic Diseases.” Int J GynaecolObstet, vol. 115 Suppl 1, pp. S11-5, 2011.
[22]  K. Ghosh, R. Colah, M. Manglani et al. “Guidelines for Screening, Diagnosis and Management of Hemoglobinopathies.” Indian J Hum Genet, vol. 20, no. 2, pp. 101-119, 2014.
[23]  P. J. Aggett, S. BarclayJ. E. Whitley. “Iron for the Suckling.” ActaPaediatrScandSuppl, vol. 361, pp. 96-102, 1989.
[24]  P. R. Dallman. “Nutritional Anemias in Childhood: Iron, Folate and Vitamin B12.” In Textbook of Pediatric Nutrition, edited by R.M. Suskind and L. LewinterSuskind, 91-105. New York: Raven Press, 1993.
[25]  H. J. Kim, D. H. Kim, J. E. Lee et al. “Is It Possible to Predict the Iron Status from an Infant's Diet History?” Pediatr Gastroenterol Hepatol Nutr, vol. 16, no. 2, pp. 95-103, 2013.
[26]  V. Shaw, U. McCrann. “Great Ormond Street Hospital. Infant Feeding: Weaning.” Great Ormond Hospital.
[27]  World Health Organization. “Infant Young Child Feeding Counselling: An Integrated Course.”
[28]  S. Zlotkin. “Clinical Nutrition: 8. The Role of Nutrition in the Prevention of Iron Deficiency Anemia in Infants, Children and Adolescents.” CMAJ, vol. 168, no. 1, pp. 59-63, 2003.
[29]  J. H. Chang, W. S. Cheong, Y. H. Jun et al. “Weaning Food Practice in Children with Iron Deficiency Anemia.” Korean J PediatrGastroenterolNutr, vol. 52, pp. 159-166, 2009.
[30]  N. Vendt, H. Grunberg, S. Leedo et al. “Prevalence and Causes of Iron Deficiency Anemias in Infants Aged 9 to 12 Months in Estonia.” Medicina (Kaunas), vol. 43, no. 12, pp. 947-952, 2007.
[31]  S. J. Noh, B. NaM. J. Kim. “Iron Deficiency and Early, Low-Dose Iron Supplementation in Breast-Fed Infants.” Korean J PediatrGastroenterolNutr, vol. 11, pp. 169-178, 2008.
[32]  R. D. BakerF. R. Greer. “Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age).” Pediatrics, vol. 126, no. 5, pp. 1040-1050, 2010.
[33]  I. B. Pateva, E. H. Kerling, M. Reddy et al. “Effect of Maternal Cigarette Smoking on Newborn Iron Stores.” Clin Res Trials, vol. 1, no. 1, pp. 4-7, 2015.
[34]  R. RaoM. K. Georgieff. “Iron in Fetal and Neonatal Nutrition.” Semin Fetal Neonatal Med, vol. 12, no. 1, pp. 54-63, 2007.
[35]  S. Ray, J. Chandra, J. Bhattacharjee et al. “Determinants of Nutritional Anaemia in Children Less Than Five Years Age.” Int J ContempPediatr, vol. 3, no. 2, pp. 403-408, 2016.