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Preventing iron deficiency in preschool children by implementing an educational and screening programme in an inner
Insights
Screening young children for iron deficiency in an inner city practice was feasible and successful. Dietary education contributed to a significant reduction in iron deficiency prevalence.
Area of Science:
- Pediatrics
- Public Health
- Nutritional Science
Background:
- Iron deficiency is a significant health concern in young children.
- Screening and early intervention are crucial for preventing long-term developmental issues.
- Inner-city populations often face unique challenges in accessing healthcare and nutritional support.
Purpose of the Study:
- To evaluate the feasibility and acceptability of screening young children for iron deficiency in a deprived inner-city general practice.
- To assess the impact of a targeted dietary education program on iron deficiency rates.
- To determine the effectiveness of integrating screening into routine immunization appointments.
Main Methods:
- A prospective study involving 127 children aged 13-24 months in a deprived inner-city practice.
- Comparison with historical control data from 110 children of similar age.
- Screening for iron deficiency (low mean cell volume and hemoglobin concentration) and hemoglobinopathy offered during routine immunizations.
- Mothers received antenatal and postnatal dietary education.
Main Results:
- Screening uptake was high, with 96% of attending children (90% of eligible) screened.
- Iron deficiency was identified in 8% of children, all responsive to iron supplements.
- A significant reduction in iron deficiency prevalence was observed compared to historical controls (8% vs. 25%).
- Hemoglobinopathy traits were found in eight children.
Conclusions:
- Integrating iron deficiency and hemoglobinopathy screening into routine childhood immunizations is feasible and acceptable in deprived inner-city settings.
- Dietary education appears to be an effective component in reducing iron deficiency prevalence.
- This approach successfully identified at-risk children and facilitated timely intervention.
Objective:
To assess the feasibility and acceptability of screening young children for iron deficiency in a deprived inner city practice and to assess the effects of a programme of dietary education.
Design:
Prospective study of children in general practice, comparison with historical controls.
Setting:
A deprived inner city practice.
Patients:
127 Children aged 13-24 months. Findings were compared with those in 110 children of the same age studied previously.
Interventions:
All mothers received dietary education antenatally and in the first year after giving birth. Screening for iron deficiency (defined as mean cell volume less than 75 fl and haemoglobin concentration less than 105 g/l) and haemoglobinopathy (when appropriate) was offered for all children attending for immunisation against measles, mumps, and rubella over 12 months; capillary blood samples were taken after immunisation.
Main Outcome Measures:
Uptake of the screening programme expressed as the percentage of all children eligible for immunisation who were screened, and the effectiveness of the dietary education as shown by the prevalence of iron deficiency in the two groups.
Results:
Altogether, 122 of the 127 (96%) children who attended for immunisation had their haemoglobin concentration and mean cell volume measured; 90% of all children aged 13-24 months in the practice were screened. Dietary education, clinical procedures, and counselling were incorporated successfully into the clinic's work. Ten children (8%) were iron deficient, all of whom responded to iron supplements, and eight had a haemoglobinopathy trait. In the previous study 110 children (70%) had been screened and 28 children (25%) had been iron deficient. The two groups were similar in terms of sex, social class, and ethnic group.
Conclusions:
Screening young children for iron deficiency, sickle cell disease, and thalassaemia when they attended for immunisation was acceptable and successful in a socially deprived inner city practice. Dietary education may have accounted for some of the reduction in the prevalence of iron deficiency that occurred over the two years.