Impact of iron therapy on Mentzer index and red cell distribution width index in primary school children with iron deficiency anemia

  • Budi Andri Ferdian
  • Nelly Rosdiana
  • Bidasari Lubis
Keywords: anemia, iron supplementation, RDW, Mentzer

Abstract

Background Iron deficiency anemia (IDA) remains a common
nutritional problem, especially in school-age children. Due to
the many examinations that are needed to be performed and the invasive gold standard procedure, an easy and simple alternative examination to diagnose IDA is needed.
Objective To determine the impact of iron therapy on Mentzer
and red cell distribution width (RDW) indexes of children with
IDA.
Methods A randomized open clinical trial was conducted in
primary school aged children in North Aek Nabara, between
November 2006 and November 2007. IDA was determined based
on WHO criteria. Subjects with severe anemia were excluded.
Subjects were randomly assigned to groups that received either
iron therapy or a placebo.
Results Three-hundred subjects from aged 9 to 12 years old
were recruited and 104 subjects completed the study. The mean
RDW index of the iron and placebo groups after three months
observation were 239.96 (SD 39.25) and 235.17 (SD 31.77),
respectively. The mean Mentzer index mean for the iron therapy
and placebo groups after three months observation were 16.08
(SD 1.98) and 16.20 (SD 2.27), respectively.
Conclusion After therapy, there are no significant differences in
either the Mentzer or RDW indexes between the therapy and
placebo groups.

Author Biographies

Budi Andri Ferdian
Department of Child Health, Medical School, University of
North Sumatera, H. Adam Malik Hospital, Medan, Indonesia.
Nelly Rosdiana
Department of Child Health, Medical School, University of
North Sumatera, H. Adam Malik Hospital, Medan, Indonesia.
Bidasari Lubis
Department of Child Health, Medical School, University of
North Sumatera, H. Adam Malik Hospital, Medan, Indonesia.

References

1. Stoltzfus RJ. Defining iron-deficiency anemia in public health
terms: a time for Reflection. J Nutr. 2001;131:S565-7.
2. Dallman PR. Nutritional anemia. In: Rudolph AM, Hoffman
JIE, Rudolph CD, editors. Rudolph Pediatrics. 20th ed.
Connecticut: Appleton & Lange, 1996; p. 1176-80.
3. Raspati H, Reniarti L, Susanah S. Anemia defisiensi besi.
In: Permono B, Sutaryo, Ugrasena IDG, Windiastuti E,
Abdulsalam M, editors. Buku ajar hematologi onkologi anak.
Jakarta: BP-IDAI, 2005; p. 30-43.
4. McGregor SG, Ani C. A review of studies on the effect of
iron deficiency on cognitive development in children. J N utr.
2001; 131 :S649-68.
5. Wu AC, Lesperance L, Bernstein H. Screening for iron
deficiency. Ped Rev. 2002;21:171-8.
6. Sandoval C, Jayabose S, Eden AN. Trends in diagnosis and
management of iron deficiency during infancy and early
childhood. Hematol Oneal Clin N Am. 2004;18:1423-38.
7. Asih R, Ugrasena IDG, Permono B, Soeparto P. Kegunaan
indeks eritrosit untuk diagnosis anemia defisiensi besi. In:
Abstract of Pertemuan Ilmiah Tahunan Ilmu Kesehatan
Anak II Ikatan Dokter Anak Indonesia (PIT IKA II IDAI).
Batam: IDAI, 2004; p. 101.
8. Wulan DR, Ugrasena IDG, Permono B. Pemeriksaan red
distribution width sebagai penunjang penegakan diagnosa
anemia defisiensi besi pada anak. In: Abstract Pertemuan
Ilmiah Tahunan Ilmu Kesehatan Anak II Ikatan Dokter
Anak Indonesia (PIT-IKA II IDAI). Batam: IDAI, 2004; p.
126.
9. Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I,
Purwanto SH. Perkiraan besar sampel. In: Sastroasmoro S,
Ismael S, editors. Dasar-dasar metodologi penelitian klinis.
Jakarta: Sagung Seto, 2008; p. 311.
10. Schwartz E. Iron deficiency anemia. In: Behrman RE,
Kligman RM, Arvin AM, editors. Nelson textbook of
pediatrics. 17th ed. Philadelphia: Saunders, 2004; p. 1614-
16.
11. Dallman PR, Yip R, Oski FA. Iron deficiency and related
nutritional anemias. In: Nathan DG, Oski FA, editors.
Hematology of infancy and childhood. 4th ed. Philadelphia:
Saunders, 1993; p. 413-46.
12. Irwin]], Kirchner JT. Anemia in children. Am Fam Physician.
2001;64:1379-86.
13. Will AM. Iron metabolism, sideroblastic anemia, and iron
overload. In: LilleymanJS, Hann IM, Blanchette VS, editors.
Pediatric hematology. 2nd ed. London; Churchill Livingstone,
2000; p. 105-26.
14. Iron Deficiency Anaemia. Assessment, Prevention and
Control. A guide for programme managers. New York: WHO,
2001; p. 14-22.
15. Wright CM, Kelly J, Trail A, Parkinson KN, Summerfield
G. The diagnosis of borderline iron deficiency: result of a
therapeutic trial. Arch Dis Child. 2004;89: 1028-31.
16. Demir A, Yarali N, Fisgin T, Duru F, Kara A. Most reliable
indices in differentiation between thalassemia trait and iron
deficiency anemia. Ped Int. 2002;44:612-6.
17. Beyan C, Kaptan K, Ifran A. Predictive value of discrimination
indices in differential diagnosis of iron deficiency
anemia and beta-thalassemia trait. Eur J Haematol. 2007;
78:524-6.
Published
2009-08-31
How to Cite
1.
Ferdian B, Rosdiana N, Lubis B. Impact of iron therapy on Mentzer index and red cell distribution width index in primary school children with iron deficiency anemia. PI [Internet]. 31Aug.2009 [cited 12Nov.2024];49(4):195-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/552
Section
Articles
Received 2016-09-10
Accepted 2016-09-10
Published 2009-08-31