Prevalence of and Factors Associated with Iron Deficiency among Thai Toddlers Aged 12 - 36 Months in The Well Child Clinic of Luang Pho Taweesak Hospital
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Abstract
Objective: This study was designed to establish the prevalence of, and factors associated with, iron deficiency among Thai toddlers aged 12 – 36 months in the well child clinic of Luang Pho Taweesak Hospital, Nong Khaem district, Bangkok.
Method: Cross-sectional study, 136 Thai toddlers aged 12–36 months were seen in well child clinic of Luang Pho Taweesak Hospital between December 2015 and August 2016 and enrolled in the study. Children with past history of malabsorption, hematological diseases, chronic illness, GI tract surgery, or receiving therapeutic dose iron supplement therapy during past 6 months, past blood transfusion during last 3 months, acute illness and/or cured less than 2 weeks before blood sampling were excluded. The subjects were interviewed by demographic questionnaires and seven – day recall method questionnaires. The blood sample was sent for CBC and serum ferritin.
Results: The prevalence of iron deficiency (ID) was 13.24%, iron deficiency anemia (IDA) was 5.15%, when determined by serum ferritin (SF) <10 µg/L. The prevalence rates of ID and IDA were increased if the SF was <12 µg/L (2.2% and 47.79%) and <30 µg/L (0.73% and 11.76%), respectively. Factors associated with iron deficiency using cutoff value of SF <10 µg/L was post-secondary maternal education (OR 4.14). Using cutoff value of SF <30 µg/L, prevalence of ID was 61.03%. Risk factors were irregular iron supplementation (OR = 6.37), Inadequate iron intake <5.8 mg/day (Thai RDA) and <7 mg/day (Institute of Medicine) (OR = 2.82 and 2.97). Protective factor was being underweight. Subjects who had supplemented iron had higher levels of SF than those who had irregularly supplemented iron. (p = 0.042).
Conclusion: The prevalence of ID among Thai toddlers aged 12 -36 months in well child clinic of Luang Pho Taweesak Hospital were 13.24% and 61.03% when determined by SF <10 µg/L and <30 µg/L, respectively. Factors associated with iron deficiency included post-secondary maternal education, irregular iron supplementation, iron intake less than 5.8 mg/day and 7 mg/day. This study showed that regular iron supplementation increased levels of SF. Universal screening of ID should include an assessment of risk factors associated with ID.
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