Preventing and controlling iron deficiency anaemia through primary health care : a guide for health administrators and programme managers

Abstract

A guide to the full range of technical and practical considerations required for the design of direct, inexpensive, and effective strategies to combat iron deficiency anaemia. Noting that this condition impairs the lives of over 700 million persons worldwide, the book makes a special effort to show how new knowledge about the technical means for prevention and control can be used to reach the largest numbers at the lowest possible costs. Throughout, emphasis is placed on problems and pitfalls, particularly in developing countries, that need to be considered when selecting the most appropriate measures for control. The opening chapters provide essential background information about the complex causes of iron deficiency anaemia, the many factors that influence its etiology, and the corresponding implications for assessment and treatment. A chapter devoted to etiology and epidemiology includes a thorough explanation of iron requirements, intake, and bioavailability useful in understanding why some individuals are at greater risk than others. Details range from a table indicating recommended daily iron intakes to examples of dietary combinations, commonly found in developing countries, that either enhance or inhibit iron absorption. Against this background, the book turns to the practical problems of assessment, treatment, and prevention. A chapter concerned with anaemia screening and the detection of iron deficiency critically compares available laboratory tests, pointing out advantages and drawbacks likely to be encountered under field conditions in developing countries. Readers are then given detailed information on treatment options using iron tablets, liquid preparations, or tablets including folate or ascorbic acid, on he recommended dosage and duration of therapy, and on side-effects associated with specific preparations and known to cause poor compliance. Information on prevention concentrates on four basic approaches involving supplementation with medicinal iron, education and associated measures to increase dietary iron intake, the control of parasitic and other infections, and the fortification of a staple food with iron. The book concludes with a discussion of the costs and benefits of prevention and a guide to the components, goals, and logistics of an anaemia control programme