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Iron deficiency, Anemia & Folate Deficiency: National Micronutrient Survey 2011-12

Iron deficiency, Anemia & Folate Deficiency: National Micronutrient Survey 2011-12. Dr. Tahmeed Ahmed Director, Centre for Nutrition and Food Security, icddr,b. Sampling. 15000 Primary Sampling Units (MICS 2009). 50 Rural. 1 st stage: 150 Primary Sampling Units . 50 Urban. 50 Slum.

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Iron deficiency, Anemia & Folate Deficiency: National Micronutrient Survey 2011-12

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  1. Iron deficiency, Anemia & Folate Deficiency: National Micronutrient Survey 2011-12 Dr. Tahmeed Ahmed Director, Centre for Nutrition and Food Security, icddr,b

  2. Sampling 15000 Primary Sampling Units (MICS 2009) 50 Rural 1st stage: 150 Primary Sampling Units 50 Urban 50 Slum 2nd stage: 50 household segments 3rd stage: 20 households

  3. Primary Sampling Units of the Survey

  4. Study Population Iron Deficiency & Anemia Preschool children (6-59 month) School age Children (6-14 years) Non Pregnant Non Lactating Women (15-49 years) Folate Deficiency Non Pregnant Non Lactating Women (15-49 years)

  5. Sample size Adjusting for Infection Ferritin is adjusted for infection by CORRECTION FACTORS David Thurnham 2010 Reina Engle-Stone 2011

  6. Results

  7. Prevalence Iron Deficiency(%) Iron deficiency: S. ferritin <12ng/ml (Pre-school) S. ferritin <15ng/ml (NPNL and School age)

  8. Dietary Intake of Iron

  9. MNP coverage in children 6-23 mo

  10. Groundwater Iron Status in Bangladesh NPNLW 68 ng/ml vs. 44 ng/ml (p<0.001) PSAC 39 ng/ml vs. 23 ng/ml (p<0.001) NPNLW 57 ng/ml vs. 42 ng/ml (p<0.001)

  11. Drinking of tube well water and iron deficiency

  12. Multivariate Regressions showing association of ferritin Independent Variables: Age, Education, Occupation, Residence, Morbidity, Dietary Intake, SES, Household Food Insecurity, Knowledge about iron related health issues, serum level of retinol, zinc, folate and hemoglobin and Groundwater iron level Dependent Variable: Serum Ferritin

  13. Multivariate regression showing associations of serum ferritin in PSAC

  14. Multivariate regressions showing associations of serum ferritin in SAC

  15. Multivariate Regressions showing associations serum ferritin in NPNLW

  16. Summary of Positive Associations of Ferritin Preschool children Hemoglobin Age “High” Iron area School age children Hemoglobin Agricultural profession “High” iron area Absence of diarrhea Serum Retinol NPNL Women Hemoglobin “High” iron area “Richest” quintile “Moderate” food insecurity Serum B12 Serum Folate Possession of Refrigerator S. Ferritin

  17. Summary of negative associations of serum ferritin Preschool children Slum residence School children Mother’s lack of knowledge that iron rich food is healthy NPNL women Household expense S. Ferritin

  18. Prevalence of anemia (%) Anemia: Hemoglobin <11 gm/dl (Pre-school) Hemoglobin <12 gm/dl (NPNLW)

  19. Prevalence of anemia (%) Anemia: Hemoglobin <11.5 gm/dl (School age, 6-11 y) Hemoglobin <12 gm/dl (School age, 12-14 y)

  20. Multivariate Regressions showing association of hemoglobin Independent Variables:Age, Education, Occupation, Residence, Morbidity, SES, Household Food Insecurity, Possession of Assets, Serum level of Ferritin, Retinol, Zinc, Folate, and Groundwater Iron level Dependent Variable: Hemoglobin

  21. Multivariate regression showing associations of hemoglobin in PSAC

  22. Multivariate regressions showing association of hemoglobin in SAC

  23. Multivariate regressions showing associations of hemoglobin in NPNL

  24. Summary of positive associations of hemoglobin Preschool children Serum ferritin Serum retinol Age “High” iron in water Absence of measles in last 6 mo Urban residence Agricultural profession School children Household expense Serum ferritin Serum retinol Age Urban residence NPNL women 7-day animal iron intake Serum ferritin Serum retinol Serum folate Serum zinc Hemoglobin

  25. Summary of negative associations of hemoglobin Preschool children “Moderate” household food insecurity Non possession of mobile phone School children Poor SES Agricultural profession Being a girl child Non-possession of refrigerator NPNL women “Mild” household food insecurity Hemoglobin

  26. Prevalence of folate deficiency(%) S. Folate level <6.8 nmol/l (Lindstorm et al 2011)

  27. Dietary intake of folate by strata

  28. Dietary Intake of folate by household food security in women

  29. Dietary intake of folate in women (400 µg/d) 160 µg/d Only 5.5% women meet the RDA RDA: 400 µg/d

  30. Multivariate regressions showing association of serum folate in women Independent Variables: Household expense, Dietary folate intake, Residence, Assets, Serum level of ferritin, retinol, SES, Household food insecurity Dependent Variable: Serum Folate

  31. Multivariate regression showing associations of folate in NPNL women

  32. Summary of positive associations of folate in women Intake of plant source folate Serum ferritin Serum retinol Rural residence S. Folate Summary of negative associations of folate in women Non-possession of refrigerator S. Folate

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