A change in risk factors and prevalence of iron-deficiency anemia among Egyptian infants 6–24 months old in Cairo, compared to a decade ago

Background
Iron-deficiency anemia (IDA) is common among children aged 6–24 months, primarily due to inadequate iron intake. Since the publication of prevalence data on ID and IDA in 2012, changes in risk factors will be highlighted in this study.


Design and methods
A cross-sectional study was conducted on 410 apparently healthy infants aged 6–24 months who attended the outpatient clinic of Ain Shams Children’s Hospital from June 2021 to June 2022. Data included dietetic history, birth order and parent’s education, and laboratory investigations, including hemogram, iron profile, and hemoglobin electrophoresis.


Results
The mean age was 14.8±4.2 months. Out of 410 infants, 208 (50.7%) were anemic, with 5% classified as having severe anemia. ID was identified in 179 (42.6%) infants, 8.1% had ID alone and 34.5% had IDA. Among the anemic infants, 175 (84.1%) had microcytic anemia. Serum ferritin levels ranged from 1 to 88 ng/ml, with a median of 14 ng/ml (interquartile range=9), and transferrin saturation ranged from 0.5 to 22%, a median of 12% (interquartile range=4). Additionally, 9.1% of anemic infants were confirmed to have β-thalassemia minor. Compared to a decade ago, a significant drop in the prevalence of IDA was almost by one-third due to a drop in family size, less unmodified cow milk feeding, and earlier introduction of iron-rich food.


Conclusion
There has been a decline in the prevalence of IDA, likely attributed to the earlier introduction of iron-rich diets, lower birth order, and better maternal education compared to a decade ago. However, IDA was ~10 times higher than that of β-thalassemia minor.