Why anaemia in infants can’t be solved by iron supplementation alone: Notes from the ethnic underground

Abstract

Aim: Our objective was to estimate the trends in incidence of anaemia among Israeli infants aged 9 to 18 months.

Methods: This was a cross-sectional retrospective study for the years 2002, 2007 and 2012 in two districts. Data was analyzed for geographic distribution, age, infant’s haemoglobin level, ethnic origin, type of clinic where the infants received treatment, iron prescriptions dispensed to each child, and the mother’s last haemoglobin level before delivery.

Results: The prevalence in District A for the aforementioned timeline was 16.2%, 9.9% and 8.1%, respectively (P<0.000). Prevalence was significantly higher in the non-Jewish versus the Jewish population. In District B prevalence was 10.8%, 11.6%, and 8.7%, respectively, and significantly higher in the non-Jewish (17.5%, 18.6%, and14.1%) than in the general Jewish population (9.0%, 9.8% and 7.5%). Among the ultra-Orthodox urban Jews, prevalence was 14.5% 14.9 %, and 11.3%, respectively.

Conclusions: Anaemia in infants is multifactorial in origin and depends on both inherent biological as well as environmental factors. Effective early prevention mitigates factors across ethno- and economic divisions.

Current knowledge on the subject: World Health Organization estimates anaemia prevalence at 47.4% and as affecting 293 million young children globally. The highest prevalence is in Africa (67.6%) and South-East Asia (65.5%). In the Eastern Mediterranean, the prevalence is 46% and around 20% in other WHO regions. In the United States, 7% to 9% of toddlers (1 to 3 years old) have iron deficiency, and 2% to 3% have iron deficiency anaemia ). In Iran the frequency of IDA was 4% and in Jordan 72%. In Israel the prevalence rate of anaemia in the year 2006 was 15.5%.

Contribution of our study to knowledge: In districts A and B there was a significant decrease in the percentages of prevalence of anaemia through the years 2001-2002, 2006-2007, and 2011-2012. Analysis of the total sample of district A revealed an almost 50% decrease, i.e. from 16.2% to 8.1%. In district B, the percentages in Jews dropped from 9% to 7.5%, in the non-Jews from 17.5% to 14.1%, and in the Ultra-Orthodox from 14.5% to 11.3%.