title: A community-based iron supplementation program, "Iron-Like Turkey", and the following prevalence of anemia among infants aged 12-23 months.
abstract: During the second year of the "Iron-like Turkey" Project, in which all children aged 4-6 months in Turkey receive iron supplementation for 5 months, we aimed to assess the utilization of iron supplementation in the field, as well as the prevalence of anemia in healthy infants aged 12-23 months, while determining a variety of sociodemographic and nutritional factors for anemia in three of the 12 NUTS (Nomenclature of Territorial Units for Statistics) regions (regions with the highest, lowest and middle under-5 malnutrition levels). In a community-based, cross-sectional survey using a multi-staged, weighted, cluster-selected sample, children aged 12-23 months with birthweight ≥2500 g, no chronic illness, no history of blood disease, and from term and singleton pregnancy were enrolled; 1589 children met the criteria. The mean±SD age of children surveyed was 17.8±3.6 months. Of the parents, 72.4% claimed that their physician had recommended iron supplementation, and 68.8% had given supplementation to their children. Overall prevalence of anemia was 7.3%. Multivariate analysis revealed that the frequency of anemia decreased significantly in older infants, when supplementation was recommended by health providers, when an infant was breastfed longer than 6 months, and when the mother received iron supplementation during pregnancy. However, anemia prevalence increased when the infant received iron supplementation at a later age (³9 months), lived in a crowded family (³6 persons), and when the mother had a history of iron deficiency anemia. Anemic infants had significantly lower z scores of weight for age than non-anemic ones. This survey suggests that iron supplementation during pregnancy, initiation of iron supplementation in infants at 4-6 months of age, effective counseling on supplementation, subsequent compliance, support of breastfeeding, and effective training of health care personnel are effective strategies for prevention of anemia in the community.
authors.affiliation: Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey. siyalcin@hacettepe.edu.tr
authors.forename: S Songül
authors.initials: SS
authors.lastname: Yalçın
authors.forename: Başak
authors.initials: B
authors.lastname: Tezel
authors.forename: Kadriye
authors.initials: K
authors.lastname: Yurdakök
authors.forename: Gülden
authors.initials: G
authors.lastname: Pekcan
authors.forename: Sema
authors.initials: S
authors.lastname: Ozbaş
authors.forename: Eda
authors.initials: E
authors.lastname: Köksal
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tunç
authors.forename: Selvi
authors.initials: S
authors.lastname: Sahinli
authors.forename: A Tanju
authors.initials: AT
authors.lastname: Altunsu
authors.forename: M Rifat
authors.initials: MR
authors.lastname: Köse
authors.forename: Turan
authors.initials: T
authors.lastname: Buzgan
authors.forename: Recep
authors.initials: R
authors.lastname: Akdağ
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007501:Iron / Q000008:administration & dosage*; D015995:Prevalence; D014421:Turkey / Q000453:epidemiology
chemical_list: D007501:Iron