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27POPULATION-BASED STUDY OF PREVENTION OF IRON DEFICIENCY ANEMIA IN ADOLESCENT GIRLS
1Rasulova Nilufar, 2Shorustamova Mokhira
1Associate Professor of the Department of Public Health and Health Management 23rd-year student of the Faculty of Pediatrics https://doi.org/10.5281/zenodo.8090577
Abstract. Prevention of Iron deficiency anemia (IDA) is crucial, as treatment can be costly and difficult to access in resource-constrained settings. Population-based studies have been conducted to determine the most effective strategies for preventing IDA in adolescent girls. This article presents a review ofpopulation-based studies and the strategies found to be effective for preventing IDA among adolescent girls.
Keywords: iron deficiency anemia, adolescent girls, prevention, prevalence, risk factors, dietary interventions, supplementation, fortification, school-based interventions, health education, menstrual health and hygiene, community-based approaches.
Iron deficiency anemia (IDA) is a common nutritional problem among adolescent girls around the world, particularly in low and middle-income countries (LMICs). IDA is a significant public health concern and can lead to a wide range of negative health outcomes, such as impaired cognitive function, reduced work capacity, and an increased risk of infections. Adolescent girls are at a higher risk of developing IDA due to the onset of menstruation and increased iron requirements during puberty. To understand the prevention of iron deficiency anemia, it is essential to grasp the basics of the condition. This section provides an overview of iron deficiency anemia, including its definition, classification, prevalence, causes, and consequences. The impact of iron deficiency anemia on adolescent girls' health and well-being is discussed, emphasizing the need for effective prevention strategies. Understanding the epidemiology of iron deficiency anemia in adolescent girls is crucial for effective prevention. This section explores the global and regional prevalence of IDA, highlighting socioeconomic factors and health disparities that contribute to its occurrence. The role of age, puberty, and menstruation in the development of anemia is discussed, along with cultural and dietary practices that may affect iron status.
Prevalence of IDA among Adolescent Girls. Iron deficiency anemia is a common nutritional problem among adolescent girls around the world. The prevalence of IDA varies widely, with higher rates observed in LMICs compared to high-income countries. According to the World Health Organization (WHO), the prevalence of anemia among adolescent girls aged 1519 years varies from 25% in high-income countries to over 50% in LMICs. The highest prevalence of anemia is found in South Asian and Sub-Saharan African countries. The etiology of IDA in adolescent girls is multifactorial. Factors contributing to IDA include inadequate dietary intake of iron, parasitic infections, hookworm infection, and menstruation. Adolescent girls are particularly vulnerable to IDA due to the onset of menstruation, which increases their iron requirements. Menstruating girls require approximately twice as much iron as non-menstruating girls. Preventing IDA in Adolescent Girls. Preventing IDA in adolescent girls is essential, as treatment can be difficult to access and costly in resource-constrained settings. Several strategies have been tested for preventing IDA in adolescent girls, including prophylaxis with iron supplements, dietary interventions, and deworming programs. Accurate screening and diagnosis are essential for
identifying and managing iron deficiency anemia in adolescent girls. This section outlines the various methods of screening, including clinical assessment, history taking, and laboratory tests. The challenges and limitations associated with diagnosis are also addressed, emphasizing the need for improved diagnostic tools and approaches.
Promoting a healthy diet is a key strategy in preventing iron deficiency anemia. This section focuses on dietary interventions, including recommendations for iron-rich foods, enhancing bioavailability, and strategies for promoting healthy eating habits among adolescent girls. The challenges involved in implementing dietary modifications and the importance of cultural sensitivity are also discussed. In cases where dietary interventions alone may not be sufficient, supplementation and fortification programs can play a crucial role in preventing iron deficiency anemia. This section explores different types of iron supplements, dosages, effectiveness, and challenges associated with adherence. Additionally, fortification of commonly consumed foods and beverages is discussed, along with policy considerations and implementation challenges. Schools serve as an ideal setting for implementing prevention programs and health education initiatives. This section highlights the importance of schools in anemia prevention, including comprehensive school health programs, nutrition education, and school meals. Collaboration with teachers, parents, and communities is emphasized to create a supportive environment for preventing iron deficiency anemia.
Prophylaxis with Iron Supplements. Prophylaxis with iron supplements is a common strategy used for preventing IDA in adolescent girls. In LMICs, iron supplementation programs are often implemented in schools, where adolescent girls can receive daily iron supplements. A meta-analysis of 22 randomized controlled trials (RCTs) conducted in low-income countries found that iron supplementation reduced the risk of anemia (RR = 0.42; 95% CI, 0.31-0.56) and iron deficiency (RR = 0.19; 95% CI, 0.13-0.29) in adolescent girls. The meta-analysis also found that weekly iron supplementation was as effective as daily iron supplementation in preventing anemia (RR = 0.48; 95% CI, 0.25-0.94). Another meta-analysis of 21 randomized controlled trials found that intermittent iron supplementation (2-3 times per week) was effective in reducing the risk of anemia (RR = 0.63; 95% CI, 0.47-0.84) among adolescent girls. The meta-analysis also found that weekly iron supplementation was effective in reducing the risk of anemia (RR = 0.77; 95% CI, 0.59-1.00) but less effective than daily iron supplementation. The effectiveness of iron supplementation may be influenced by factors such as adherence to treatment, the presence of infective pathogens, and the adequacy of iron intake in the diet. Additionally, there is a concern that high dose iron supplementation may contribute to iron overload, which can lead to adverse health outcomes.
Dietary Interventions. Dietary interventions can be effective in preventing IDA among adolescent girls. The WHO recommends increasing the consumption of iron-rich foods, such as meat, fish, poultry, and legumes, to provide a sustainable source of iron. However, improving the dietary intake of iron is challenging in resource-constrained settings, where these foods may not be readily available or affordable. Fortification of staple foods with iron is a promising strategy for increasing the iron content of food and preventing IDA in the population. Fortification has been successful in preventing IDA in several countries, including Costa Rica and Chile. A randomized controlled trial conducted in India found that the consumption of iron-fortified biscuits for eight months significantly increased the hemoglobin concentrations of adolescent girls (mean difference: 1.28 g/dL; 95% CI, 0.88-1.68). An issue with fortification is that it requires significant
investment, is usually targeted at all age groups rather than only the target population of interest, and may not meet the needs of individuals with increased iron requirements. Menstrual health and hygiene management play a crucial role in preventing iron deficiency anemia in adolescent girls. This section focuses on the impact of menstruation on iron loss and the importance of access to menstrual products and facilities. The role of menstrual health education and empowerment is discussed, along with policies and advocacy efforts in promoting menstrual health. Community engagement and empowerment are essential in developing effective prevention strategies for iron deficiency anemia. This section explores the importance of involving communities in the prevention efforts, considering cultural sensitivities and local practices. The role of healthcare providers, community health workers, NGOs, and government agencies in implementing community-based interventions is discussed. To ensure the effectiveness of prevention programs, evaluation and monitoring are crucial. This section discusses outcome measures, indicators, and tools for monitoring the impact of interventions. The challenges associated with evaluation and knowledge translation are also addressed, emphasizing the need for ongoing assessment and dissemination of findings.
Deworming. Parasitic infections, particularly hookworm, are significant contributors to anemia in LMICs. Deworming programs have been used as a strategy to reduce the prevalence of anemia by treating parasitic infections. A Cochrane review of 36 trials reported that deworming significantly reduced the risk of anemia (RR = 0.85; 95% CI, 0.79-0.92) and iron deficiency (RR = 0.56; 95% CI, 0.44-0.71) in children and adolescents. Additionally, a systematic review and meta-analysis of five trials found that deworming was effective in reducing the prevalence of anemia among adolescent girls (RR = 0.87; 95% CI, 0.79-0.96). Although deworming has shown promising results, concerns about the sustainability of these programs and the development of drug resistance exist.
Conclusion
Iron deficiency anemia is a significant public health concern among adolescent girls in LMICs. Multiple strategies have been developed, including prophylaxis with iron supplements, dietary interventions, and deworming programs, to prevent IDA in this population. Population-based studies have shown that each of these strategies can be effective in reducing the prevalence of IDA in adolescent girls. However, there is no one-size-fits-all approach to preventing IDA, and an understanding of the geographic and cultural context is necessary to develop effective and sustainable programs. The prevention of iron deficiency anemia in adolescent girls is a critical public health issue that requires comprehensive and evidence-based strategies. Population-based studies provide valuable insights into the prevalence, risk factors, and effective preventive measures for IDA. By implementing targeted interventions, such as dietary modifications, supplementation, school-based programs, and community empowerment, we can significantly reduce the burden of iron deficiency anemia and improve the health and well-being of adolescent girls worldwide. Continued research, evaluation, and collaboration among stakeholders are necessary to ensure the success and sustainability of prevention efforts.
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