An evaluation of the treatment for pediatric anemia in the Tennessee WIC program

The purpose of this investigation was to evaluate the treatment provided for pediatric anemia in three selected East Tennessee counties and to determine any differences between treatment responders and nonresponders which may be contributing to the relatively high rate of nonresponse found in the anemic pediatric WIG population in Tennessee. Of the 1507 children screened for anemia in the 3 clinics, 3.5% were found to be anemic (i.e., hematocrit less than 31% for children less than 24 months of age and less than 34% for children 24 to 54 months of age). The response rates among the anemic children in the three clinics varied from 29.5% in the urban WIG clinic to 64.3% and 66.7% in the two rural clinics. An evaluation of the distribution of initial hematocrits by county revealed that children with hematocrits of 32% or 33% are less likely to respond than the children with hematocrits less than 32%. This phenomenon also was evident when the treatment response rates by initial hematocrit were examined. A significantly higher response rate was noted among the children with initial hematocrits of less than 32% when compared to those children with initial hematocrits of 32% or 33% (81.8% versus 37.9%). This finding was confounded by the issuance of a greater dosage of supplemental iron to those children in the lower hematocrit range, however. Both an increased potential for false positive diagnoses common to the upper ranges of low hematocrit measures and the smaller dosages of supplemental iron were suggested as contributing to the lower response rate among those children with hematocrits of 32 or 33%. Other demographic variables associated with response were sex, age, previous certification for WIC, educational level of father and growth centiles, although these differences were not significant.

Recommendations for a more effective program for the treatment of Iron deficiency anemia In the Tennessee WIC Program were made. Including the need for regional nursing and nutritionist training programs on the diagnosis and treatment of Iron deficiency anemia. Issuance of Iron supplements by weight and" the Implementation of the hematocrit percentiles as a criterion for anemia.