IRON DEFICIENCY ANEMIA AS A RISK FACTOR FOR ACUTE LOWER RESPIRATORY TRACT INFECTION IN CHILDREN

Pediatrics

Background: Anemia is a major nutritional global problem of immense public health significance. Acute lower respiratory tract infections (ALRTI) is the leading cause of mortality and morbidity in children under- five years of age. Iron deficiency might forms an indirect risk factor for ALRTI.The study was conducted to determine the relationship between iron deficiency anemias as a risk factor in acute lower respiratory tract infection in children of age 6 months to 5 years. Methods and Materials: Hospital based cross-sectional descriptive study was conducted at Nepalgunj Medical College, Nepalgunj, Nepal from February 2013 to January 2014. 82 children having ALRTI as per WHO criteria were investigated for Iron Deficiency Anemia (IDA). Statistical analysis of the data was done using SPSS, version 17. Descriptive analysis, bivariate analysis using ‘t’ independent test and chi square test and multiple linear regression analysis done with level of significance at p value < 0.05. Findings: Among children, 87.8% were between age group 6 months to 24 months of age with male preponderance (1.5:1). Majority(79.3%) of the patients had pneumonia and remaining 20.7% were bronchiolitis. One third of the children met all six criteria for IDA (as per WHO), majority (78%) of cases had Hb level less than 11gm/dl.Mean of the hemoglobin (Hb), total RBC count, hematocrit, MCV, MCH, MCHC, RDW, serum ferritin were significantly different among the iron deficiency positive group and iron deficiency negative group with highly significant p value < 0.01. MCV and MCH as a strong predictors of iron deficiency anemia with OR [-0.01(-0.03-0.01)], p value of 0.02 and OR [-0.07(-0.13—0.003)], p value of 0.04 respectively in ALRTI. Conclusion: Hence IDA can be taken as a indirect risk factor of ALRTI and iron supplementation along with appropriate and adequate complementary feed in children above 6 months of age can be a cheap, dependable, cost effective prevention of anemia and consequently an indirect measure to reduce the incidence of ALRTI.

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