Thalassemia carrier status and groundwater iron: Implication for iron supplementation program for children in Bangladesh.

IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Sabuktagin Rahman, Patricia Lee, Moududur Rahman Khan, Faruk Ahmed
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引用次数: 0

Abstract

Background: Thalassemia, a congenital disorder of hemoglobin synthesis is characterized by low hemoglobin and high iron status, is prevalent in Bangladesh. Iron, consumed through drinking groundwater also increases the population iron status in Bangladesh. The study examined the effect of iron containing micronutrient powder (MNP) on the hemoglobin and ferritin status in Bangladeshi children with thalassemia and their non-thalassemia peers exposed to a high concentration of iron from drinking groundwater.

Design and methods: Three hundred twenty-seven children aged 2-5 years were recruited for an MNP efficacy trial. A sub sample (n = 222) were screened for thalassemia. Hemoglobin and ferritin levels were measured in children with and without thalassemia. Intake of iron from the key sources-diet, groundwater and MNP was measured. Mann Whitney and t-test were employed to compare the groups.

Results: Hemoglobin concentration of the children with thalassemia at the endpoint remained unchanged relative to the baseline; 11.56 ± 0.59 g/dL (Endpoint) versus 11.6 ± 0.54 g/dL (Baseline), p = 0.83. In children without thalassemia hemoglobin tended to increase; 12.54 ± 0.72 g/dL (Endpoint) versus 12.41 ± 0.72 g/dL (baseline), p = 0.06. Baseline reserve of body iron was significantly (p = 0.03) higher in thalassemia carriers (594 gm) compared to their non-carrier peers (558 gm). The increase of the infection-adjusted ferritin from baseline to the endpoint was 7.37% (p = 0.7) and 10.17% (p = 0.009) in the carrier and non-carrier groups respectively.

Conclusions: In Bangladesh, the coexistence of thalassemia and the exposure to a high concentration of iron from drinking groundwater renders anemia prevention program with a low iron MNP potentially lesser hazardous to the thalassemia carriers.

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地中海贫血携带者状况和地下水铁:对孟加拉国儿童补铁计划的影响。
背景:地中海贫血是一种先天性血红蛋白合成障碍,其特征是血红蛋白低和铁含量高,在孟加拉国很普遍。通过饮用地下水消耗的铁也增加了孟加拉国人口的铁含量。该研究检查了含铁微量营养素粉末(MNP)对孟加拉国地中海贫血儿童及其非地中海贫血儿童暴露于饮用地下水中高浓度铁的血红蛋白和铁蛋白状态的影响。设计和方法:招募327名2-5岁儿童进行MNP疗效试验。对一个子样本(n = 222)进行了地中海贫血筛查。测定了地中海贫血儿童和非地中海贫血儿童的血红蛋白和铁蛋白水平。测定了主要来源-饮食、地下水和MNP的铁摄入量。采用Mann Whitney检验和t检验进行组间比较。结果:地中海贫血患儿在终点时血红蛋白浓度相对于基线保持不变;11.56±0.59 g / dL(端点)和11.6±0.54 g / dL(基线),p = 0.83。在没有地中海贫血的儿童中,血红蛋白趋于升高;12.54±0.72 g / dL(端点)和12.41±0.72 g / dL(基线),p = 0.06。地中海贫血携带者(594 gm)体内铁的基线储备明显高于非携带者(558 gm) (p = 0.03)。从基线到终点,感染调整铁蛋白在携带者组和非携带者组分别增加了7.37% (p = 0.7)和10.17% (p = 0.009)。结论:在孟加拉国,地中海贫血的共存和饮用地下水中高浓度铁的暴露使得低铁MNP的贫血预防方案对地中海贫血携带者的潜在危害较小。
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来源期刊
Journal of Public Health Research
Journal of Public Health Research PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.70
自引率
4.30%
发文量
116
审稿时长
10 weeks
期刊介绍: The Journal of Public Health Research (JPHR) is an online Open Access, peer-reviewed journal in the field of public health science. The aim of the journal is to stimulate debate and dissemination of knowledge in the public health field in order to improve efficacy, effectiveness and efficiency of public health interventions to improve health outcomes of populations. This aim can only be achieved by adopting a global and multidisciplinary approach. The Journal of Public Health Research publishes contributions from both the “traditional'' disciplines of public health, including hygiene, epidemiology, health education, environmental health, occupational health, health policy, hospital management, health economics, law and ethics as well as from the area of new health care fields including social science, communication science, eHealth and mHealth philosophy, health technology assessment, genetics research implications, population-mental health, gender and disparity issues, global and migration-related themes. In support of this approach, JPHR strongly encourages the use of real multidisciplinary approaches and analyses in the manuscripts submitted to the journal. In addition to Original research, Systematic Review, Meta-analysis, Meta-synthesis and Perspectives and Debate articles, JPHR publishes newsworthy Brief Reports, Letters and Study Protocols related to public health and public health management activities.
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