Article Text
Abstract
Aims The aim of our retrospective chart review is to identify causes and improve management of iron deficiency anaemia (IDA) amongst toddlers in outpatient paediatric clinics.
Methods This is a retrospective chart review of children, aged 6 months to 2 years old, who were diagnosed with IDA over 1 year study period in outpatient clinics. Identification of cases with iron deficiency anaemia were from outpatient pharmacy who were prescribed iron supplements during the study period.
Results Over the study period, 52 cases of iron deficiency anaemia were diagnosed. Mean age of the cases was 11 months old and the mean haemoglobin level was 10 ± 1.4 g/Dl at diagnosis. Children on complete breastfeeding have a significantly lower haemoglobin compared to those on mixed or formula feeding (p = 0.01).
Thalassaemia screen were positive in 14 out of 32 cases screened. Mentzer index was significantly lower in patients with positive thalassaemia screen versus patients without thalassaemia (p = 0.00).
Patients referred to dietician showed a significant improvement in haemoglobin compared to those who were not referred. (p = 0.16) Compliance to iron administration were assessed in 29 cases, with 6 were assessed to be non-compliant. Patients who were compliant to iron supplements showed a non-significant improvement in haemoglobin compared to those who were non-compliant (p = 0.5).
Conclusion Mentzer index is useful to distinguish between IDA and thalassaemia. Assessing compliance and involving dietician are important factors in improving haemoglobin levels. Children on complete breastfeeding should be advised on iron rich diet or regular iron supplementation.