Prevalence and risk factors for iron deficiency in Kelantanese pre-school children.

Introduction: To determine the prevalence of iron deficiency (ID) and iron deficiency anaemia (IDA) in Kelantanese pre-school children and to identify risk factors that best predict the presence of ID. Methods: Children (aged eight to 26 months) who attended eight primary health clinics in the district of Kota Bharu, Kelantan, Malaysia, from September to November 1999, were invited to participate in the study. Parents were interviewed for potential risk factors of ID and blood was taken for the analysis of haemoglobin (HB), mean corpuscular volume and serum ferritin (SF) level after obtaining a verbal consent. The possible risk factors for ID were compared between the iron deficient (SF less than 12 microgrammes per litre) and iron sufficient (SF greater than 12 microgrammes per litre) groups using multiple logistic regression. Results: Among 490 children, 319 (65.1 percent, 95 percent confidence interval [Cl] 60.7-69.2 percent) had anaemia (HB less than 11.0 g/dL). 191 children (38.9 percent, 95 percent Cl 34.7-43.5 percent) had ID. 155 children (31.6 percent, 95 percent Cl 27.6-36.0 percent) had IDA (HB less than 11.0 g/dL and SF less than 12 microgrammes per litre). Independent risk factors for ID were prolonged breast feeding for more than six months (p-value is 0.003, adjusted odds ratio [OR] 2.5, 95 percent Cl 1.5-4.0) and failure to receive formula milk (p-value is 0.004, adjusted OR 1.6, 95 percent Cl 1.2-2.0). Other dietary factors were not significantly associated with ID. Conclusion: The prevalence of ID and IDA among Kelantanese children is high, and is mainly attributed to prolonged breast feeding beyond six months of age and failure to introduce formula milk at later infancy.