Authored by Robizon Tsiklauri*
Abstract
Background: Until 2015, systematic statistical data on micronutrient deficiency was not available in Georgia, to provide developing national strategy. In the same year, the National Centre for Disease Control and Public Health of Georgia (NCDC) in collaboration with the USA CDC launched the project “Strengthening surveillance of micronutrient deficiency in Georgia”.
Methodology: Sentinel surveillance approach was used by selecting 8 sentinel sites from 4 regions, 2 sites in each region (1 pediatric and 1 antenatal clinic). Folate and iron deficiencies were studied in pregnant women (1st trimester) and iron deficiency was measured in children (12- 23 months old). Ferritin concentration in plasma with cut-off points of <12 μg/l was used for Iron deficiency measure in toddlers, and <15 μg/l in pregnant. <3.0 ng/ml was considered as a cut-off point of Folate deficiency in pregnant. For anemia detection for the both target groups (children U2; pregnant) has been used Hb cut-off points of <11 g/l. Hemoglobin was tested using HemoQue and Multi-analyzer techniques at the sentinel sites.
Findings: In 2016-2017, Blood hemoglobin was measured among 939 children 12 to 23 months of age. 34% were anemic. Furthermore, 478 were tested for iron deficiency and 84% of them were identified as iron deficient. Hemoglobin was tested among 2,790 pregnant women and 7.4 % of them were found anemic. Additionally, 483 of 2,790 pregnant women were tested for iron and folate deficiencies. 61% were iron deficient, and 26.4% tested positive for folate deficiency. Neural tube defects (NTDs) prevalence per 1000 live births registered in sentinel sites was high 2.7.
Conclusion: Our preliminary results show that anemia and iron deficiency are prevalent among both pregnant women and children of the specified age group in Georgia. Additionally, folate deficiency was quite common during the 1st trimester of pregnancy. Our findings will inform public health policy decision makers to take relevant decisions on required interventions, such as health education, distribution of relevant supplements, and food fortification.
Introduction
Globally, micronutrient deficiencies affects approximately 2 billion people. Major morbidity and mortality are associated with vulnerable populations notably children under five and pregnant woman. Major micronutrient deficiencies include iron, folate and iodine [1]. In 2013, iron deficiency anemia affects 27% of the world’s population. More than 89% of the burden comprises low income countries. Iron-deficiency anemia causes more than 60% of anemia in the general population. Children under five and women of reproductive age are particularly vulnerable by anemia, which occurs when red blood cells are below the normal level.
Epidemiological studies for assessing the micronutrient status among the population in the South Caucasus region which includes Georgia, Azerbaijan, and Armenia, are limited. Reports from Armenia (2000) estimated the prevalence of anemia to be 12 % and 12.4% among pregnant women and non-pregnant women, respectively and to be 23.9% in children under five [2].
A nationwide survey in Georgia reported prevalences of 22.8% anemic children, 25.6% in pregnant and 36.6% in non-pregnant women.
Iron is an essential element for the biosynthesis of blood hemoglobin. The symptoms of iron deficiency anemia can be mild at first and are not diagnosed until they have a routine blood test. Potential health complications of iron deficiency anemia include rapid or irregular heartbeat, pregnancy complications of premature birth or low birth weight, and delayed growth in infants and children [3].
Folate insufficiency manifests in neural tube defects (NTDs), which is caused by low concentration of vitamin B9 (folate) in blood. Approximately 190,000 neonates are born with NTD in low Income Countries. TDs are serious and most common consequence of folic acid deficiencies. NTDs occur when neural tube closure is completed by embryonic day 28 of pregnancy and arise when the neural tube cannot close properly. The most common NTDs are the following: anencephaly and spina bifida [4].
Potential target groups
Potential target groups for surveillance of micronutrient deficiency are infants, toddlers, preschool children, school-age children, and women of childbearing age (ref). Toddlers are vulnerable to micronutrient deficiencies, are accessible for the assessment in child health clinics and community surveys and are an indicator of risk in the general population. Surveillance of iron deficiency is focused on these vulnerable groups. In the present study women at the 1st trimester of pregnancy was studied.
Gap in knowledge
The last assessments of nutritional status have been done in Georgia in 2009 [5], but they do not contribute substantially to the estimation of nationwide prevalence rates of nutritional outcomes. Currently we are establishing national nutrition monitoring and surveillance system in Georgia (GNMSS). Findings of this could provide policy makers with reliable, valid data for developing national strategy of micronutrient deficiency elimination and improving the nutritional status of population.
To read more about this article..Open access Journal of Nutrition & Food Science
Please follow the URL to access more information about this article
To know more about our Journals....Iris Publishers
No comments:
Post a Comment