Background: Iron deficiency is the commonest form of malnutrition worldwide and according to the World Health Organization affects 43% of the world’s children. In children it is frequently caused by dietary deficiency, because milk has low iron content. It is develops when there is inadequate iron for hemoglobin synthesis and is the result of imbalance between iron assimilation and iron loss.   

Method: This prospective hospital based study was conducted on 100 children between 6 months to 5 years, admitted in pediatrics department of Rural tertiary care hospital, Mullana. Children with Thalassemia, malignancy, and bleeding disorders were excluded. 2 ml of venous blood anti-coagulated with EDTA was taken and complete blood counts (Hb, TLC, DLC, Platelet count, Red cell indices), peripheral blood film and S.ferritin estimation was done.            

Results: Serum ferritin had a mean value of 40.676 ng/ml (min: 0.1ng/ml;  max 246.6ng/ml) It was 31.86 ng/ml for age group 6-24 months, 52.35 ng/ml for 25-36 months and 55.035 ng/ml for age group 37-60 months, showing rising trends of serum ferritin with age. Mean hemoglobin of the children is 8.84gm/dl (with minimum being 2.4gm/dl and maximum 10.9 gm/dl), median being 9.45g/dl. Microcytic Hypochromic anemia was seen in 72% children while Normocytic and Normochromic anemia was seen in 28% of children.

Conclusion: Peripheral blood film and RBC indices although aid to diagnose the type of anemia, where resources permit serum ferritin estimation should be done as is the only sensitive test to diagnose iron deficiency anemia in initial stages. This results in prevention of the children to progress from iron deficiency (depleted iron store) to the iron deficiency anemia and its morbid consequences.

Keywords:  Serum ferritin, Iron deficiency anemia, Microcytic-Hypochromic, anemia.

1. World Health Organization, The World Health Report 2002: Reducing Risks, Promoting Healthy Life, World Health Organization, Geneva, Switzerland, 2002
2. Kleigman RM, Stanton BF, St. Geme JW, Schor NF, Bherman RE. Nelson textbook of pediatrics. 19ed. India. Elsevier; 2011: 1656
3. Hanumante NM, Kanvinde S, Sanwalka N J, Vaidya M V and Khadiker A V. Iron deficiency anemia in urban slum. Indian J Pediatr.2008;75(4):355-57.
4. Sharma D, Mathur R, Singh P. Iron metabolism. A Review. Indian Journal of Biochemistry, 8(2): 80-102; (1993).
5. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and Mineral Nutrition Information system. Geneva, World Health Organization, 2011 (WHO/NMH/NHD/MNM/11.2)
6. Inoka P. Anemia in chronic kidney disease in children. Reviews. Galle Medical Journal 2007, (1):27.
7. Serum ferritin levels in anemia & rheumatoid arthritis. J Rheumatol.1977, 3: 389.
8. White KC. Anemia is a poor predictor of iron deficiency among toddlers in the United States: for heme the bell tolls. Pediatrics 2005;115:315–20.
9. World Health Organization. Worldwide prevalence of anemia 1993-2005: WHO Global Database on Anemia. Geneva: WHO; 2008.
10. B. Lerner and R. Sills, “Iron deficiency anemia,” in Nelson Textbook of Pediatrics, R. M. Kliegman, B. F. Stanton, J. St. Geme, N. Schor, and R. E. Behrman, Eds., pp. 1655–1658, Elsevier Saunders, Philadelphia, Pa, USA, 19th edition, 2011.
11. World Health Organization, Preventing and Controlling Iron Deficiency Anemia through Primary Health Care, A Guide for Health Administrators and Programme Managers, WHO, Geneva, Switzerland, 1989.
12. World Health Organization, Iron Deficiency Anemia Assessment, Prevention, and Control, A Guide for Programme Managers, WHO, 2001
13. Akin F, Solak ES, Kilicaslan C, Boke SB et al. Iron deficiency anemia among hospitalized children in Konya, Turkey. Hindawi publication corporation 2013;27: 9.
14. Kadiver MR, Yarmohammadi H, Mirahmadizadeh AR, et al. Prevalence of iron deficiency anemia in 6 months to 5 years old children Fars, South Iran, Med Sci Monit 2003;9(2): 100-104.
15. Mei Z, Cogswell ME, Parvanta I, Lynch S, Beard JL et al. Hemoglobin and ferritin are currently the most efficient indicators of population response to iron intervention: An analysis of nine randomized controlled trails. J Nutr 2015; 135: 1974-80.
16. O' Meara, Infanti L,Stebler C, Ruesch M, Sigle JP et al. The value of routine ferritin measurement in blood donors. 2011; 51:2183-88.
17. S. Phiri, J. C. J. Calis, A. Siyasiya, I. Bates, B. Brabin, and M. Boele van Hensbroek, “New cut-off values for ferritin and soluble transferrin receptor for the assessment of iron deficiency in children in a high infection pressure area,” Journal of Clinical Pathology, vol. 62, no. 12, pp. 1103–1106, 2009.
18. NNMB-National Nutrition Monitoring Bureau: Prevalence of micronutrient deficiency. NNMB Technical report no.22, National Institute Of Nutrition Hyderabad, India; Indian Council Of Medical Research;2003
19. Khan AS, Shah SA. Iron deficient children and significance of serum ferritin. J Pak Med Assoc; 55: 420-23.

Dr Bablu Kumar Gaur

Flat No- 11, E Block, M.M Residential Complex, MMU, Mullana, Ambala (Haryana), India

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