Frequency of Iron Deficiency in Children With Hypochromia and Microcytosis on Blood Smears

Background: The relationship between iron deficiency and certain phenomenon like hematological alterations, inadequate growth, altered thermoregulatory function and reduced cognitive function have been well known. Objectives: To determine the frequency of iron deficiency in children with hypochromic and microcytic anemia on blood smears. Methods: This case-control study was performed in the department of pediatrics, Sahiwal Teaching Hospital, Sahiwal, Pakistan from May 2022 to April 2023. For cases, we included 179 children of both genders aged between 1 month and 15 years with hypochromia and microcytosis. Similar number of healthy children (n=179) of both gender and aged below 15 years were enrolled as controls. At the time of enrollment, socio-demographic information like gender, age and residential area were recorded. Local institutional laboratory was utilized for the hematological parameters. Hypochromia and microcytosis were labeled as MCV< 76fl and MCHC < 30 g/dl of red cells while blood film also depicted hypochromia and microcytosis. IDA was termed as serum ferritin < 12 ng/dl. Results In a total of 358 children, there were 192 (53.6%) boys. The mean age was 7.8±3.2 years while 184 (51.4%) children were between 6-15 years. Residential status of 196 (54.7%) children was rural. Overall, iron deficiency was diagnosed in 209 (58.4%) children. Among cases, 171 (95.5%) children had iron deficiency while among controls, 38 (21.2%) children had IDA (p<0.0001). Cases and controls were compared for various hematological laboratory parameters and statistically significant differences were observed for all parameters among cases and controls (p<0.0001). Conclusion: The frequency of iron deficiency was 95.5% among children with hypochromia and microcytosis on blood smears. Hematological parameters were significantly deranged among children with hypochromia and microcytosis when compared to healthy children.