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العنوان
Iron Deficiency Anemia among Children during Weaning /
المؤلف
Abd Elreheem,Dalia Ali Mohamed.
هيئة الاعداد
باحث / Dalia Ali Mohamed Abd Elreheem
مشرف / Nawal Mahmoud Soliman
مشرف / Ferial Fouad Melika
تاريخ النشر
2019
عدد الصفحات
267p.;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
المجتمع والرعاية المنزلية
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية التمريض - صحة مجتمع
الفهرس
Only 14 pages are availabe for public view

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Abstract

Anemia is a global public health problem in both developing and developed countries with major consequences for human health (Galit et al., 2014). The prevalence of iron deficiency anemia (IDA) remains high in late infancy and early childhood despite the increased breastfeeding rate, improvements in public health, and development of iron-fortified foods. IDA is associated with impaired neurocognitive function and exercise intolerance, and the association exists even after its successful treatment (Joo et al., 2016).
Aim of the Study
This study was carried out to assess iron deficiency anemia among children during weaning.
Research questions
1. Is there a relation between the mothers’ knowledge and practices about iron deficiency anemia?
2. Is there a relation between the mothers’ knowledge and children health problems related to iron deficiency anemia? 3. Is there a relation between the mothers practices and children health problems related to iron deficiency anemia?
4. Is there a relation between socio demography of mothers and their practices?
Methodology: Research design:
A descriptive design was used in this study. Setting
This study was conducted at 3 maternal and child health center (MCH) in Shoubra El Khemia which had been chosen randomly from total 14 MCH centers as (Begam MCH, Osman MCH, Nopar MCH). Subjects
A purposive sample was used in this study which consisted of 500 children with iron deficiency anemia and their mothers from the previous mentioned setting.
Inclusion Criteria:
The Children were selected according to the following criteria:1. Children were diagnosed with iron deficiency anemia.
2. The children’s age was from 6 months to2 years.
Tools of data collection
Data collected through used the following tools:
The first Tool: an interviewing questionnaire was used to collect data about:
Part 1:
It was used to assess demographic characteristics of the study sample of children with iron deficiency anemia and socio-demographic characteristics of their mothers. This part included 15 closed ended questions such as age, gender, and child birth order for children and fathers’/mothers’ age, educational level, and their job, family type and income also home status such as residence and crowding index.
Part 2:
It was used to assess mothers’ knowledge about iron deficiency anemia which included 8 closed ended questions regarding meaning of iron deficiency anemia, causes, symptoms, food rich in iron, complications of iron deficiency anemia, diagnostic measures, treatment, and the preventive measures.Part 3:
It was used to assess mothers’ practices about prevention of iron deficiency anemia among children during weaning which consisted of 27 open and closed ended questions divided into three parts as follow:
a. Mothers’ practices about breast feeding.
b. Mothers’ practices about weaning.
c. Mothers’ practices towards nutrition for their children with iron deficiency anemia.
Scoring system for practices questions: A scoring system for each of practical items as reported by mothers correctly was scored ”1”, and each item not reported or incorrectly scored ”zero”. All items of practices were summed and changed into percentage. The total items = 27 questions take 44 grads (100%) which categorized into two levels as follow:
- Inadequate practices = >50%; (0: >20)
- Adequate practices = <50% (20: 44)
Part 4:
It was used to assess the risk factors of iron deficiency anemia during weaning among children which consisted of 38 closed ended questions Yes or No, divided into five parts as follow:
a. Assessment of child medical history during labor.
b. Assessment of child medical history.
c. Assessment of child health history of weaning.
d. Assessment of types of medication.
e. Assessment of child follow up and immunizations.
Part 5:
It was used to assess the health needs among children with iron deficiency anemia during weaning which consisted of 20 closed ended questions divided into four sections; first section includes (1- 9 questions) about nutrition pattern, second section includes (10- 12 questions) for fluid needs, third section includes (13- 16) sleeping needs, and fourth section includes (17- 20 questions) for personal hygienic needs for children.
The second tool: Medical follow up record was used to assess health status of the children with iron deficiency anemia which consisted of three sections as follow:
a. Physical health status.
b. Laboratory investigation.c. The clinical manifestations
The third tool: Assessment of Children According to Denver Developmental Screening Test (Denver scale):
The development assessment tool (An observational check list): the developmental items was assessed according to age 6 months, 9months, 12months ,18months, and 24 months and every item take one grade if found and zero for not found.
Each of the items summed up and the total items = 17 item for 6 months. 19 items for 9 months, 28 for 12months, 24items for 18months, and 27for 24 months converted into percentage. The total items were categorized to each different age to determine the developmental level as the following category:
 Poor developmental level= Less than >60%
 Moderate developmental level = 60: 85%
 Good developmental level = more than 85%
Results
The main study findings can be summarized as follows:
 The highest percentage of the study sample of children (46.2%) were in the age group 18: 24months; their mean age was15.58 ± 6.192 months. Also 52.4% of studied children were male and 31.6% and 34.8% of them their birth order were the first and second child respectively.
 45.6% of fathers and 68.8% of mothers were in the age group 20 - < 30 years. Regarding to educational level, 62.0% of fathers and 48.0% of mothers were had average level of education. 44.8% of fathers were employees and 71.6% of mothers were housewives. 52.0% of family hadn’t enough income. As well as, 80.4% of families lived in urban area and 60.4% of them lived in overcrowded homes.
 9.2% of the mothers have satisfactory knowledge and 90.8% of them have unsatisfactory knowledge about iron deficiency anemia during weaning among their children.
 89.4% of the mothers were had inadequate practices toward prevention of iron deficiency anemia among their children during weaning.
 56% of children suffered from diarrheal diseases and 54.4% of them suffered from respiratory tract infection.
 88.6% of children were had breastfeeding while 11.4% of them were had bottle feeding, and 49.6% of children their weaning process started after completion of 6 months. 49.6% of children never took cow’s milk before the completion of one year. 19.6% were suffered from allergy.  As regard to nutritional needs during weaning, 52.8 % of children were rarely eat some meals include sweets and sugars. As regard to fluid needs, 34.4 % of children were rarely not to drink cow’s milk before the age of one year. In relation to sleeping needs, 32.4 % of children were rarely sleep less than 8 hours continuously. In relation to personal hygienic needs, 26.4 % of mothers were rarely clean the child’s mouth and teeth after eating.
 6.4% of children with iron deficiency anemia had good level of health needs achievement and 62% of them had poor level of health needs achievement.  Children with 6 months age, 9 months, 12months, 18months and 24 months age had good social and emotional developmental level, language/ communication, cognitive (learning, thinking, problem-solving), movement/physical development  65.2% of children with iron deficiency anemia had good level of development and 30% of them had moderate level while 4.8% of them had poor level.
 40.6% of children with iron deficiency anemia were underweight and 6% of them were short as well 94.8% of them had abnormal serum hemoglobin.
 There was a highly statistical significant relation between the mothers’ knowledge and practices about iron deficiency anemia with X2 =21.032 and P value >0.001
 There was statistically insignificant relation between the mothers’ knowledge and children’s level of development with X2 = 2.583 and P value <0.05
 There was statistically insignificant relation between the mothers’ knowledge and children’s physical growth level as body weight, length, head /chest circumference, teething, and serum hemoglobin with P value <0.05.
 There was statistically insignificant relation between the mothers’ knowledge and children’s iron deficiency anemia `clinical manifestations with P value <0.05.  There was statistically significant relation between the mothers’ practices and children’s level of development with X2 = 8.326 and P value >0.05.
 There was statistically significant relation between the mothers’ practices and children’s physical growth level as length and head circumference with P value >0.05.
 There was statistically insignificant relation between the mothers’ practices and children’s iron deficiency anemia `clinical manifestations with P value <0.05.
 There was statistically significant relation between the mothers’ practices and their socio demographic characteristics as mother’s age with X2 = 8.990 and mother’s educational level with X2 =12.37 and P value > 0.05.
Conclusion
On light of the current study results, it can be concluded that, there was a highly statistical significant relation between the mothers’ knowledge and practices about iron deficiency anemia. Moreover, there was statistically significant relation between the mothers’ practices and children’s level of development. Also, there was statistically significant relation between the mothers’practices and their socio demographic characteristics as mothers’ age and educational level. Meanwhile, there was statistically insignificant relation between the mothers’ knowledge and children’s level of development.
Recommendations
The main recommendations can be summarized as follows:
 Educational programs should be designed and constructed for mothers regarding iron deficiency anemia during weaning to promote their knowledge and practice to prevent this health problem.
 Further research studies are needed for ongoing assessment of children and their mothers including large sample for generalization of results.