Iron Deficiency Anaemia

          Iron Deficiency Anaemia

Abstract

Iron deficiency is a global issue that causes ill-health in both developed and developing countries. Iron deficiency causes anemia in children, pregnant women, and other vulnerable groups. When the deficiency emanates from a lack of iron in the diet, addressing this specific problem is the key to preventing the onset of iron-deficiency anemia. Taking this step is not a reserve of one specific person. Actors in the government, public service, medical field, and non-governmental organizations are called to collaborate in implementing programs that ensure adequate intake of iron especially for children and pregnant mothers. Legislation of policies is also necessary to establish long-lasting solutions for this problem.

Introduction

Anemia remains a global public health issue of concern due to its associated morbidity and mortality. Among the different types of this disease, Iron-deficiency anemia (IDA) poses a significant risk to people with chronic illness, pregnant women, and malnourished children. Patients with gastrointestinal problems like celiac disease and conditions that require gastrectomy are also at a high risk of developing iron-deficiency anemia. The focus of this paper will be on the iron deficiency that results from malnutrition or malabsorption of this element in the stomach due to the absence of other nutritional components like ascorbic acid, citric acid, and amino acids. Foods rich in iron help to balance the body’s reserves of iron and prevent the onset of IDA. At the same time, proteins, fruits, and vegetables are necessary to complement the physiological mechanism involved in the uptake of iron in the gastrointestinal cells (Lanham-New et al., 2019).

The purpose of this paper is to establish a connection between nutritional deficiency and pathology. The background of this nutritional research is minerals, which form an integral part of diet balancing. Besides carbohydrates, vitamins, proteins, and fats, minerals help to run various physiological systems in the body. They are critical constituents of bones, act and co-enzymes, and comprise biomolecules like hemoglobin and other proteins in the body (Lanham-New et al., 2019). Therefore, this analysis will relate iron deficiency and iron-deficiency anemia and explain what interventions are workable in the prevention of this disease.

The primary audience of this paper is comprised of nutritionists and dieticians. Additionally, policymakers at national and local levels will find the reading informative especially on the areas of disease prevalence and interventional measures. This paper may inform decision-making in addressing malnutrition. Some of the policies that may develop as a result of reading this work are the creation of nutritional awareness, mandatory fortification of foods, and distribution of supplemented meals to refugees, homeless people, and street children. Medical professionals like nurses and patient attendants will learn about the risk of IDA among various patient profiles like the elderly, chronically ill patients, and malnourished children in hospitals and rescue facilities.

The importance of this paper stems from the prevalence of IDA in the community. The discussion is centered on a pathology whose root cause is nutrition. IDA belongs to a class of nutritional disorders whose remedy lies in proper dietary habits, especially when the etiology is the lack of iron in food. This topic is important because the prevalence of IDA is high, yet the interventions rarely address the root cause. This high prevalence calls for enhanced public awareness about food that people eat, nutritional imbalance in takeout and fast food, and the daily recommended dietary intake of minerals like iron. Observably, information about iron is not readily available in the public domain. The commercials that hint at this area are for promotional purposes, meaning that the affordability and reliability concerns arise from the dissemination of information regarding the intake of minerals. Thus, a discussion of IDA will inform measures meant to prevent the disease, treat already confirmed cases, and ensure that reliable information on dietary iron is available for public consumption.

Prevalence and statistics of IDA

Iron-deficiency anemia affects millions of people across the world. Warner and Kamran (2021) note that 25% of all people in the world have anemia. Being the most common form of anemia, IDA accounts for 50% of all anemia, meaning that the prevalence of this disease in the world is 12.5%. In the United States and other developed countries, the rate of this disease is lower compared to third=world nations. Only 1% of men under 50 years have IDA, while 10% of women in the reproductive age have iron deficiency. The prevalence of IDA is 3% for children between 12 and 36 months, although the figure is higher for general iron deficiency. Pregnant women and women in the reproductive age have a higher iron demand due to developing fetus and menstruation respectively (Warner & Kamran, 2021). Young children may have lower than normal iron due to malabsorption disorders or low intake in the diet.

Effects of IDA

Iron-deficiency anemia affects people of all ages. Due to low hemoglobin concentration in blood, the level of oxygen delivery to the tissue is compromised, meaning that IDA patients will present with fatigue, dizziness, and headache. Hemoglobin is synthesized in the liver by conjugation of the heme group, protein, and iron. The iron required for hemoglobin assembly must be present in the body’s reserves. Low reserves of iron in the body mean that none is available for this process. Since hemoglobin gives blood its red color, the lack of an adequate amount of this molecule results in paler blood. It follows, therefore, that the skin, mucus membranes, and tongue will appear pale in IDA.

The lack of iron has different effects on various populations. Iron deficiency in children leads to development disorders (Abu-Ouf & Jan, 2015). Since low iron levels translate to inadequate transport of oxygen to vital tissues, children can have insufficient cognitive development when the brain does not receive enough oxygen. Iron deficiency is a general marker for malnutrition. Therefore, there is a relatively higher prevalence of infective conditions in children with low iron level than normal controls (Jayaweera et al., 2019). More specifically, children with iron-deficiency anemia show higher susceptibility to gastrointestinal, respiratory tract, and urinary tract infections. Lack of adequate oxygenation of tissues compromises their ability to mount immunity and fight against invading bacterial, viral, and fungal agents. In the lungs, for example, lack of enough oxygen in the parenchymal cells predisposes an individual to infections caused by a plethora of micro-organisms (Jayaweera et al., 2019). Studies have also shown that the rate of pediatric febrile seizures is significantly higher in children with IDA (Kwak et al. 2016).

Pregnant women have an increased risk of iron deficiency due to physiologic expansion of volume and downstream consumption of iron (Warner & Kamran, 2015). The demand for iron among teenage pregnant women is especially high since both the mother and the fetus have high iron demand (Abu-Ouf & Jan, 2015). Women who are iron deficient deliver low birth-weight children (Abu-Ouf & Jan, 2015). Fetal death is also common with such women. The affected mothers present with all symptoms of anemia, and stand a higher risk of developing pre-eclampsia, post-partum bleeding, sleep difficulties, and peri-natal infections (Abu-Ouf & Jan, 2015).

Diagnosis of Iron deficiency

Both clinical and laboratory parameters are necessary for the diagnosis of iron-deficiency anemia. However, a clinical review will not establish which type of anemia that a patient is suffering from. Signs and symptoms of IDA include paleness on palms, tongue, and eyes, dizziness, fatigue, headache, and shortness of breath. After the clinician observed these manifestations, laboratory analysis of blood is important to determine which form of anemia the patient has. Determination of hemoglobin levels will be the first test to confirm the presence of anemia. A complete blood count is also useful in calculating the mean corpuscular volume, a parameter usually reduced in IDA. Biochemical studies that complement this diagnosis are iron levels, ferritin levels, and transferrin levels.  A combination of these findings will help the clinician to make correct a diagnosis of IDA.

Prevention, Treatment, and interventions

The key to the prevention of nutritional anemia is the consumption of food that contains the right amount of iron. Beef, liver, organ meat, legumes, and leafy vegetables are good sources of iron. Fruits and vegetables are also important in availing the nutrients that are involved in the intestinal absorption of iron. Fortification of meals is fundamental in preventing iron deficiency. A study to determine the outcomes of double fortification of salt with iron and iodine showed that this intervention greatly reduces the rate of IDA in the population (Larson et al., 2021). This means that the addition of iron to food in recommended doses can help prevent IDA especially among people prone to this disease.

Fortification and supplementation form the mainstay of treatment of iron deficiency. When the patient is diagnosed with iron-deficiency anemia, the intervention depends on the severity of the disease. In severe cases, blood transfusion is conducted to restore the hemodynamic function. In mild cases, the patient is offered hematinic drugs that contain iron. The patient is then advised to take foods that are fortified with iron to ensure rapid restoration of iron stores in the body. Other interventions for addressing iron deficiency are conducted on a macro level.

For example, the creation of awareness among the public is important to educate people on the causes, dangers, and prevention of IDA. These interventions are possible through the collaborative efforts of concerned parties like dieticians, nutritionists, public health officers, governments, and non-governmental organizations. In low-income countries, the intervention should focus on the elimination of dietary habits that predispose children to iron deficiency (Mantadakis, Chatzimichael, & Zikidou, 2020). In high-income countries, IDA in children stems from poor post-natal practices like the exclusive feeding of infants with cow milk (Mantadakis, Chatzimichael, & Zikidou, 2020). Therefore, educating mothers on correct feeding practices goes a long way in addressing IDA in children. Other targeted program include the distribution of relief food to vulnerable population and introducing indiscriminate supplementation of iron to pregnant women.

Conclusion

Iron-deficiency anemia is the commonest cause of low hemoglobin among all patient profiles. While derangement in the physiological state has a role to play in the onset of this disease, poor dietary habit reduces the intake of iron, a critical component in the formation of blood. Food fortification, iron supplementation, and awareness creation are some of the interventions to address the problem at both individual and community level. However, it is imperative to create policies that ensure that IDA does not cause public health problems. Such policies include legislations that ensure equitable access to food for all people. Additionally, establishing nationwide multifaceted programs will create a method of identifying, preventing, and treating nutritional deficiencies like IDA.