The aim of the study to explore anemia in pediatric patients admitted to pediatric department in zarqa district and it's causes.

1. Anemia among Jordanian
children six months- two years
age,admitted to Azzarka state
hospital and its relation to
breast-feeding

2. Performed by
Dr.Ghassan A Shakkoury
Consultant pediatrician
Dr. Waheed Shakkoury
senior specialist in public
health

3. 1- Anemia is a common health problem in
developing countries
2- The main cause of anemia in these countries is
inadequate nutrition especially iron deficiency.
3- Iron deficiency anemia is an important cause
of psychomotor and developmental impairment in
infants.

4. Objective
To asses (by proxy)
prevalence of anemia in
children between 6m-2y
age in Azzarka region
and its relation to
breast-feeding

6. Setting and participants
All children 6m-2y age
admitted to
ped.department between
1’st November 2012 –
April/30/ 2013

7. PROSPECTIVE EXCLUSION
CRITERIA
• All children with chronic
diseases
• children with chronic hemolytic
anemias
• Children with acute hemolytic
anemias

8. 1-Patient’s medical files
during admission.
2- Direct interview with
mothers

9. Infants were diagnosed
as anemic if their Hb
value <-2SD of mean
For our targeted age group (6 M-
2Y)
Mean value is12.0gm% &
-2SD is 10.5gm%

10. Because lab.data for
serum iron &ferritin were
lacking
We used low MCV <70
FL(-2SD of mean value
for this age group) and
high RDW (>16%) as a
PROXY measures for iron

11. Some conditions other
than IDA may cause
anemia with low MCV
&high RDW
1-Thalassemia minor(EXCLUDED)
from the study
2- Lead poisoning&vit.B6 deficiency
are RARE in Jordan

12. RESULTS
• Total number of admissions (6m-2y )
age is 215, M :f ratio 1,29:1
• Total number of anemic patients is
112(52% of all admissions ) M : F
ratio, 1,2 :1,
• Total patients, with IDA are 47 (42 %
of anemic patients)

13. Total admissions

14. 112
61
51
0
20
40
60
80
100
120
Anemic
pt's
Anemic
males
Anemic
females
3-D Column 1

15. Of total anemic
children(n=112)
•67 infants on mixed
milks&added food
•45infants on breast
milk&added food

16. Total anemic patients
112
67
45
0
20
40
60
80
100
120
Total anemic Mixed
milks&added
food
Breast milk
&added food
3-D Column 1

17. Mixed milk-
fed+added
food
Anemic
patients
Yes No Total
YES 67 40 107
NO(breast-
fed +added food )
45 63 108
Total 112 103 215

18. ODDS RATIO=
2.345 CI 95%
(1.3563-4.0540)

19. OF TOTAL ADMISSIONS
• 47 infants were with IDA
• 29 were on mixed
milks&added food
• 18 were on breast
milk&added food

20. Mixed milks
+added food
Patients with
IDA
Yes No Total
YES 29 78 107
NO (Breast
milk+added
food)
18 90 108
Total 47 168 215

21. ODDS RATIO =
1.8580 CI 95%
(0.9592- 3.6028)

22. • Mean Hb level in breast-fed
children was greater than that in
mixed-milk group (10.607gm/dl
,10.052 gm/dl respectively . P- value
= 0.0042 )

23. CONCLUSION
• Anemia among admitted
children was significantly high
52% of admissions
For iron deficiency anemia
22% of admissions

24. CONCLUSION
The number of anemic children
was SIGNIFICANTLY
higher in infants who were
NOT on breast-milk & added
food compared with those
who are on BREAST
milk&added food

25. ODDS RATIO =
2.345 CI 95% (1.3563-4.0540 )

26. conclusion
The number of children with IDA was
significantly higher in mixed milks-fed
group than in breast milk-fed group
ODDS RATIO = 1.8580
CI 95% (0.9592- 3.6028)

27. conclusion
• The mean Hb level in
infants,fed with breast-milk&
added food was significantly
HIGHER than mean Hb level
in infants ,fed with mixed
milks & added food
p-value = 0.0042

28. FINAL CONCLUSION
• Breast-feeding
• SEEMS TO BE an important protective
factor against nutritional anemia in
children in this age group (6 months-2
years ) especially those who live in low-
income families, not able to ensure milk
fortified formulas

29. THANK YOU