Iron Deficiency Anaemia

Interaction

The WHO defines anaemia as being characterised by a finding of a Haemoglobin (Hb) concentration of <130 g/L in men, <120 g/L in women, and <110 g/L in pregnant women and preschool children. Clinical manifestations of iron deficiency anaemia (IDA) include weakness, headache, irritability and fatigue. Less common symptoms include glossal pain, dry mouth, alopecia and generalised pruritus. Iron deficiency, without overt anaemia, is associated with cognitive impairment in pre-schoolers, teenagers and the elderly.

The impact of even mild iron deficiency anaemia upon physical functioning of the elderly can be significant. A trial involving community dwelling elderly women found those with borderline Hb of 120–130 g/L performed worse than those with Hb 130–150 g/L on tests of walking speed, balance and ability to rise from a chair.

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A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.

Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

Indigenous Child Anaemia and the Intervention

The anaemia rate of aboriginal children in the region had nearly trebled in two years according to figures produced by Sunrise Health Service in an opinion piece in the Sydney Morning Herald. The last eighteen months of data collection were during the “intervention“.

If this is the case it reflects very poorly on the Intervention (now called the Northern Territory Emergency Response) as it was originally all about saving the kids.

But this may not be the case across all of remote Northern Territory. The ABC has Dr John Boffa from Congress (and an advisor to AMSANT) quoting data from the ‘Growth Assessment and Action Database’ which collects data on Aboriginal children from across the Territory. The data showed that across the Territory until April 2008 the anaemia rates for children had not changed and were remaining steady at 25%. Note this data is six months older than the data produced by Sunrise.

This figure of 25% is disturbing in itself. Even worse is the first year of the intervention was spent collecting all this data again, despite it already existing. They could have actually been helping kids and families. Two years in to the intervention and they are only now realising that they have a snowball’s chance in hell of providing some of the extra services required.

John Boffa says “local data needs to be analysed carefully”. There may well be valid reasons why a large area is suffering. It may be the shops not providing good food or the Basics Card (quarantined money used only for food. Money is obtained using a swipe card in selected stores) not working.

This trebling in anaemia needs to be investigated and extra resources provided long term in most areas to educate and constantly represent and work with families to correct it, and also to set up systems to prevent it. However that requires will. I am unsure that exists at a government level despite the nice words.

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