Anemia in Nicaragua

Mural of Playa Gigante in the Community Health Centre

Anemia can affect the function of every organ because a reduction in red blood cells reduces the delivery of oxygen, which is necessary for the optimal function of every cell in the body.

The causes of anemia include anything that reduces the production of red blood cells, anything that increases the destruction of red blood cells, or blood loss.

The most common cause of anemia is iron deficiency anemia. If there is not enough iron, the body cannot produce enough red blood cells.

Blood smear in iron deficiency anemia. 
Note the RBCs have a pale centre.

Iron deficiency in Nicaragua is more common than in Canada. Poverty does that. The children are often not supplemented with iron after they are weaned from the breast, and thereafter, the diet of the average Nicaraguan child is not rich in many nutrients, including iron. In Nicaragua the iron is also low because of intestinal blood loss due to worms and parasites.

In 1993 the prevalence of anemia in Nicaraguan children aged 1 to 4 years was 29%. In response to this continuing concern, the Nicaraguan Ministry of Health initiated a National Micronutrient Plan (NMP) and an Integrated Anemia Control Strategy (IACS), which was implemented in 2004. The IACS included iron and iron/folic acid supplementation for children < 5 years of age, bi-annual treatment of children 2 to 10 years of age for intestinal worms, and fortification of wheat flour with iron. Although this initiative has reduced the prevalence of anemia in Nicaraguan children, the problem continues and is likely worse in rural communities such as Gigante.

Iron deficiency anemia due to poor nutritional intake can be prevented by starting supplemental iron when an infant is weaned off breast milk. About 1 to 2 mg/kg/day of elemental iron is necessary to prevent iron deficiency anemia. Treatment of iron deficiency anemia requires supplementation with 6 mg/kg/day of elemental iron for 3 months.

With this trip to Nicaragua I am fortunate to bring a donated supply of FeraMax, an iron supplement for children, courtesy of BioSyent Pharma Inc. Thank you BioSyent Pharma Inc.