Iron deficiency disorder in Nepal

Iron deficiency is the most prevalent nutritional deficiency in the world. It is also major public health problem of Nepal associated with nutritional deficiency.

Globally, it is estimated to 1.25 billion people are affected by iron deficiency. Iron requirement s is highest during infancy, early adolescence, and pregnancy.

In infancy and early childhood, iron is required for rapid growth. In early adolescence, iron requirements are high because of the growth spurt and even higher for girls who experience both a growth spurt and onset of menses. In pregnancy, iron requirement s are driven by tissue synthesis in the mother , the placenta , and the fetus and by blood loss at delivery.

Status in Nepal

The recent NDHS (2006) revealed that anemia levels in children and women are high in Nepal. Nearly one in two (48%) Nepalese children 6-59 months old were reported to be anemic, with 26 % mildly anemic, 22 % moderately anemic, and less than 1 % severely anemic .

Source; NDHS 2006

Causes

• Inadequate intake of iron from daily diets

• Inadequate absorption of dietary iron

• Infestations such as hookworms and malaria

• High requirements of iron particularly during growth and pregnancy

• Blood loss (menstruation, and injury)

• Vitamin A deficiency

Consequences

• Impaired human function at all stages of life

• Impaired work performances, endurance and productivity

• Increased risk of maternal morbidity and mortality

• Increased risk of sickness and death for the baby

•Reduced physical capacity

•Reduced learning capacity etc.

Nepal‘s protocol for iron deficiency disorder

Prevention

• Dose; 60mg iron +400µg folic acid, daily

• Duration; from the beginning of the second trimester in pregnancy (6month)till 45 days postpartum (total 225 days)

Note; if 6 months duration cannot be achieved in pregnancy , continue during the postpartum for 6 months or increase the dose to 120 mg iron in pregnancy.

Treatment

•<2 years; 25mg iron +100-400 µg folic acid daily 3 months

• 2-12 years ; 60 mg iron +400 µg folic acid daily 3 months

• Adolescents and adults, including pregnant women ; 120 mg iron +400 µg folic acid daily 3 months.