PREVALENCE OF IRON DEFICIENCY ANEMIA AMONG CHILDREN WITH SCHOOL FAILURE AND ITS RELATION TO INTELLIGENCE QUOTIENT

Document Type : Original Article

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Abstract

Introduction: An estimated 25% of school-aged children a worldwide is anemic. Iron deficiency is thought to account for about half of the global cases of anemia and is associated with inadequate dietary Recent years have shown a growing interest and concern in many countries about the problem of school failure and the determination of its main contributing factors. This problem is known as the “one hundred factors problem” and a great deal of research has been done on identifying the factors that affect the low performance of students (school failure and dropout) at different educational levels (primary, secondary and higher).
Aim of the study: This study will be designed to evaluate the prevalence of iron deficiency anemia among children with school failure, the relationship between the degree of iron deficiency anemia (IDA) and changes in the level of intelligence quotient (IQ).
Patients and Methods: This study is a prospective study on 100 children aged from 5 to 12 years old during the period from August 2018 – October 2019 and are divided in to two groups group A with IDA and group B without IDA. The patients who will be included in our study as anemic group who have: CBC: Hgb less than 11.5gm% Low MCV, Serum Ferritin: Less than 12ng/ml, and Free Erythrocyte Protoporphyrin: Increase than 23.8mg/dl. Then after confirmation that our patients are iron deficiency anemia the following was done for anemic and non-anemic group. Intelligence quotient: IQ was assessed by Stanford _Binet Intelligence scales.
     Before and after treatment, after correction of clinical and lab manifestations.
Statistical analysis: Data were analyzed using Statistical Program for Social Science (SPSS) version 15.0. Quantitative data were expressed as mean ± standard deviation (SD). Qualitative data were expressed as frequency and percentage.
Results: Prevalence of IDA was significantly higher among children with school failure. 68% of the studied group had IDA while the other 32% had no IDA (Mean hematological values of Hb, MCV and serum ferritn; respectively were low and FEP was elevated in anemic children, our results confirmed Free erythrocyte protoporphyrin (FEP) to be the most significant factor for the diagnosis of iron deficiency anemia in children, Our result revealed that there was a significant difference in the level of IQ between anemic and non-anemic group and in our study there was improvement of IQ after treatment with iron).
Conclusion: The study found a positive correlation between IDA and poor school performance, although iron deficiency anemia (IDA) is a high risk factor for school failure but not the only cause in primary school children, free erythrocyte protoporphyrin (FEP) is the most sensitive and specific predictor for diagnosis of iron deficiency anemia in comparison to the other predictors although it is expensive.
Recommendations: Pediatricians and mass media should raise awareness about iron deficiency and its sequelae, also the importance of the presence of the pediatric clinics for those apparently normal children. Screening of iron deficiency anemia in pale children and in poor school performance children to decrease its prevalence and impact on children.
     Proper complementary early feeding with iron rich foods to decrease iron deficiency anemia between infants and children.
     Treatment of IDA should occur early as possible by dietary improvement or by oral iron supplementation by giving 6mg elemental iron/kg/day divided into 2-3 doses continued for 2-3 month after correction of anemia to replenish body stores.
     Adding iron to widespread food as bread may be beneficial for prophylaxis of IDA.

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