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Influence of infection on iron profile in severely malnourished children
M Atiar Rahman1, M A Mannan, Md Hamidur Rahman
1Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. atiar777@yahoo.com
Insights
Severely malnourished children exhibit altered iron profiles, with parasitic infections significantly impacting iron levels. Iron, total iron binding capacity (TIBC), and transferrin saturation below 16% indicate iron deficiency in these vulnerable children.
Area of Science:
- Pediatric Nutrition
- Infectious Diseases
- Hematology
Background:
- Severe malnutrition in children (12-71 months) is associated with altered iron status.
- Differentiating iron deficiency from anemia of inflammation in infected, malnourished children is clinically challenging.
Purpose of the Study:
- To investigate the iron profile in severely malnourished children with various infections.
- To identify accurate diagnostic markers for iron status in this population.
Main Methods:
- A study involving 108 severely malnourished children (72 infected, 36 non-infected) and 36 healthy controls aged 12-71 months.
- Assessment of serum iron, total iron binding capacity (TIBC), and ferritin concentrations.
Main Results:
- Severely malnourished children had lower serum iron, TIBC, and ferritin compared to healthy controls.
- Infected children showed higher ferritin than non-infected but still below normal levels.
- Parasitic infestations significantly reduced serum iron and transferrin saturation.
Conclusions:
- Reduced iron, TIBC, and transferrin saturation (<16%) are reliable indicators of iron deficiency in both infected and non-infected severely malnourished children.
- Serum ferritin elevation in infection acts as an acute phase reactant but remains low in deficiency.
- Parasitic infections and acute respiratory infections particularly impact serum iron levels.
Objective:
To study the iron profile and find out an accurate diagnostic tool which reflects iron status in different types of infection in severely malnourished children aged 12 months to 71 months.
Methods:
Hundred and Eight (108) children of whom 72 children were infected and 36 non infected severely malnourished children according to WHO criteria in the age group of 12-71 months were interrogated. 36 healthy control in the same age group were also interrogated.
Results:
Mean serum iron, total iron binding capacity (TIBC), ferritin concentration in normal children were significantly higher (P<0.001) than non-infected severely malnourished children. On the other hand mean serum ferritin concentration was significantly higher (P<0.001) in infected group than non-infected group but still lower than normal. Mean serum TIBC concentration significantly reduced in severely malnourished children than normal children but no significant difference was observed between non-infected and infected group. Mean serum iron, and transferrin saturation were significantly reduced (P<0.05) in parasitic infestation.
Conclusion:
Severely malnourished children had reduced mean serum iron profile. Parasitic infestation influenced the marked reduction of mean serum iron concentration and transferrin saturation level. Mean serum iron concentration was reduced in acute respiratory infection(ARI) and parasitic infestation than other infections. Serum ferritin concentration was elevated in all types of infection as acute phase protein but still lower than normal. So Iron, TIBC and Transferin saturation <16% constitute good evidence for iron deficiency in both infected and non-infected severely malnourished children.
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