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EGYPT: Government moves to tackle iron deficiency anaemia

CAIRO, 23 August 2011 (IRIN) - Manar Youssef from the poor southern Cairo district of Basateen in Egypt was not sure what was wrong with her daughter Basmalah until she took her to a specialist who found that she had iron deficiency anaemia (IDA).

"The girl was pale all the time and would become exhausted at the smallest effort," Youssef told IRIN. She had also complained of frequent leg pains and fainting.

Anaemia, according to the World Health Organization is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. It is mainly caused by iron deficiency and is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable.

The condition has become more prevalent in Egypt, according to Galila Mukhtar, a leading paediatrician at Cairo’s Ain Shams University, because of complex economic and social problems, malnutrition, and infections sometimes triggered by hookworm. Most cases occur among children in slums and poor districts.

While IRIN was unable to obtain any government statistics, Mukhtar reckoned, based on her own studies, that more and more people had IDA, adding that the poor rarely ate meat or vegetables, and that they tended to be more affected by pollution, which can weaken the immune system.

Head of the state-run National Nutrition Institute (NNI) Azza Gohar said: “We had an IDA rate of 46 percent in children last year. This year there was a 5 percent rise. This means that the child anaemia rate in Egypt has become 51 percent. We need to take action and plan programmes to counter this, or anaemia rates will continue to rise.”

Egypt’s 2005 Demographic Health Survey said one quarter of adolescent males and one third of females in Egypt were anaemic, according to the UN Children’s Fund (UNICEF).

Youssef said her daughter, aged seven, receives iron-and-folic-acid-fortified biscuits at school, but when she gets home, she eats mainly carbohydrate-based meals. Other people were poorer and their children in worse condition, she added.

NNI, in cooperation with UNICEF and the World Food Programme, is sponsoring a programme which gives all schoolchildren biscuits containing iron and folic acid.

Fortification plan

Ongoing concern about IDA prevalence has persuaded the authorities to plan to mix bread flour with iron and folic acid.

“We have already tested fortification in some areas,” said Fathi Abdel Aziz, assistant minister of Solidarity and Social Justice, adding that the aim was to fortify bread nationwide from 2012. The annual cost of fortifying bread would be US$10.3 million, and the government will supply special mixing machinery to bakeries. The colour of the bread and its taste will not be affected, he said.

The government is also subsidizing folic acid for pregnant women to ensure mothers get the necessary vitamins. Women are supposed to take folic acid pills for the first three months of their pregnancy, which costs them the equivalent of a modest $2.7.

“We encourage pregnant women to take folic acid on a daily basis,” said Gohar. “We have been doing this since 1998.”

Serious consequences

Anaemia, according to the World Bank, is ignored in most developing countries even though it is one of the most prevalent public health problems with serious consequences for national development. The Bank says anaemia, is one of the top 10 risk factors contributing to the global burden of disease.

According to UNICEF, there are over a dozen different types of anaemia, some due to a deficiency of either a single or several essential nutrients and others from conditions that are not related to nutrition such as infections. People suffer from non-nutritional anaemias (such as sickle-cell anaemia and thalassaemia, which are induced by genetic disorders), but these are few in comparison to the number of people with nutritional anaemia - a condition in which the haemoglobin or red blood cell content of the blood is lower than normal because of too little iron.

One study on the public health significance of IDA concludes: “IDA affects a quarter of the world’s population and is widespread in most developing countries… the true toll of iron deficiency and anaemia lies hidden in the statistics of overall death rates, maternal hemorrhage, reduced school performance and lowered productivity. It has serious effects on immunity, morbidity from infectious, physical work capacity, and cognition.”

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Theme (s): Children, Economy, Education, Health & Nutrition, Urban Risk,

[This report does not necessarily reflect the views of the United Nations]

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