Iron deficiency anemia in refugee children from Burma: A policy proposal.

摘要

Background. An estimated 135,000 refugees from Burma (Myanmar) are located within 10 camps along the Thailand/Burma border. In refugee camps worldwide, iron deficiency anemia (IDA) is routinely reported among the top medical problems. Food rations are typically inadequate in iron and long-term reliance on rations is a key predictor of anemia among displaced people. To date there have been no comprehensive nutritional assessments completed within this population.; Aims. In a survey of refugee children 6–59 months of age, the objectives were to determine: (1) prevalence of iron deficiency anemia (IDA) as assessed by a zinc protoporphyrin heme ratio (ZPP:H) >80 μmol/mol and hemoglobin 11 g/dL; (2) prevalence of anemia using hemoglobin 11 g/dL; (3) prevalence of iron deficiency (ID) identified as elevated ZPP:H and (4) if anemia and ID were primarily a result of dietary intake.; Methods. Using cluster sampling in 3 camps and convenience sampling in 2 others, 975 children were selected. Hemoglobin levels were obtained using the HemoCue machine and ZPP/H was analyzed using the ProtoFlour-Z Hematofluorometer. Logistic regression analyses determined predictors of anemia and ID.; Results. Prevalence within this population of refugee children was: IDA, 64.9%; anemia, 72%; and ID, 84.5%. Predictors of anemia from the base model included age, ration does not last, WHZ −2, elevated ZPP/H, lived in camp 1 year, father has not received any formal education, and camp. The predictors of ID were age, reported vomiting, child was not born in camp, mother has not received any formal education, and camp.; Conclusions. Laboratory tests confirmed that anemia and ID are major health risks among these refugee children and that iron deficiency is the leading cause of anemia; however, illness and diet both appear to be major contributors. A comprehensive public health approach to combating anemia and ID within this population is essential. A policy proposal to decrease the prevalence of anemia and promote improved nutrition status within this refugee population is being forwarded through the Thai Red Cross Society to the Ministry of Interior, Burmese Border Consortium (BBC) and Coordinating Committee for Services to Displaced Persons in Thailand (CCSDPT).