INCIDENCE OF ANEMIA BASED ON HAEMOGLOBIN LEVELS IN CHILDREN 2-12 YEARS OF AGED IN NOBEL MEDICAL COLLEGE TEACHING HOSPITAL, BIRATNAGAR, NEPAL

Haemoglobin levels were used to estimate the incidence of anaemia in children 2-12 years old in the population of Biratnagar,Morang Dist., Nepal. who were attending Nobel Medical College & teaching hospital. Out of 5063 subjects, 634 children’s were selectively diagnosed as anaemia. Among the 2406 children’s aged 2-6 years 5.4% were diagnosed with mild anaemia,2.7% moderate anaemia and 1.7% severe anaemia (WHO definition) of 2657 children’s aged 7-12 years,10.2% were diagnosed with mild anaemia, 3.1% moderate anaemia and 1.3% severe


Introduction:
Anaemia is the commonest problem in the growing age group in developing countries 1 .When iron deficiency is sufficient severe, Hb concentration in the blood decreases, leading to iron deficiency anaemia (IDA), which has negative health consequences, especially in children 3 , adolescents 4 .
According to the latest data more than 3 billion people throughout the world have some form of anaemia ranging from deficiency in iron resources without symptoms of anaemia to iron deficiency anaemia. 5Iron deficiency in infancy and adolescence causes mental retardation and damages the immune system, predisposing children to a wide range of disorder. 6,7ifferent studies in Egypt 8 , India 9 , Thailand 10 and the United states 11 have shown that irondeficiency anaemia in children under 5 years old and primary school students is accompanied by psychomotor retardation, low intelligence and decreased learning capability.A study in Thailand has shown that the effects of anaemia on intelligence couldn't be compensated for 10 one of the most dangerous consequences is the higher risk of poisoning with heavy elements, since the absorption of these elements increases in cases of iron deficiency. 12Recently it has been reported that preschool children have the highest prevalence of anaemia, nearly 50% across developing countries, compared with pregnant and non-pregnant women .13

Method and methodology:
This retrospective study was conducted in Nobel Medical College & Teaching Hospital ( NMCTH) with aim to serve Nepalese people.A sample size of 5063 subjects who were investigated for estimation Hb levels by Cyanmethaemoglobin method both aged 2-6 years and 7-12 years children.As anaemia is classified into three degree according to WHO: mild, moderate and severe.Hb cut-off values of anaemia for children <6 years were mild 10.0-10.9g/dl, moderate 9.0-9.9g/dl and severe< 9.0 g/dl.Hb cut-off of anaemia for children 6-12 years old were: mild 11.0-11.9g/dl, moderate 10.0-10.9g/dl and severe < 10.0 g/dl 14

Result:
Table :1: shows that 634 subjects were diagnosed as anaemia out of a total population of 5063 including both the aged 2-6 years and 7-12 years childrens in our study.The total percentage of anaemia was 24.4% comparatively among them, 241 and 393 were 2-6 years and 7-12 years children respectively.The incidence of anemia was 9.8% in 2-6 years and 14.6% in 7-12 years children.The overall incidence of anemia was significantly higher 14.6% aged 7-12 years of children.
Table:2 reperesents the status of anaemia based on Hb levels measured in 2-6 years old children, severe anaemia was seen in 1.7%, moderate anaemia was present in 2.7% and mild anemia was present in 5.4% of children .Overall incidence of anemia was 9.8%.Table : 2 also depicts the status of anemia based on haemoglobin(Hb) levels,in children 7-12 years old.Severe anemia was seen in 1.3%, moderate anemia was present in 3.1%, and mild anemia was present in 10.2% of children .The overall incidence of anaemia 14.6% .So it is significantly higher than the 2-6 years of children Discussion: Our retrospective study one of the hospital based study.The study shows that anaemia should be considered as a major health problem in Biratnagar, dist., Morang, Nepal.In total 9.8% of 2-6 year old children and 14.6% of 7-12 year-old children suffered from anaemia (Hbs 11.0 g/dl).According to the WHO classification if 5%-25% of the population have anaemia or abnormal Hb , the degree of population anaemia is graded mild .7A study in the United states (US) in 1976-80 showed the rate of anaemia to be around 6% in 2-6 year-old children. 15Anaemia is present in 27% of 1-6 year-old children in the Philippines, 27%-44% in 3-5 year-old children in India and 24% in 2-5 year-old children in Romania. 16Another report showed that Asian children suffer from micronutrient deficiencies, especially iron deficiency anaemia and the prevalence of iodine-deficiency anaemia was 40-50% in preschool and primary-school children. 17e world Health organization has proposed that if the prevalence of anaemia in a region is between 5% and 20%, appropriate interventions based on food diversification, food fortification, iron supplementation and controlling infectious diseases should be considered. 7Weekly iron supplementation for school children considered for primary schools.Fortification of foods (Such as iron fortification of biscuits) is another strategy which could be considered for preventing iron deficiency among Nepalese school children.