Published online August 28, 2006
PEDIATRICS Vol. 118 No. 4 October 2006, pp. e1055-e1060 (doi:10.1542/peds.2006-0024)
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ARTICLE

The Incidence of Anemia in an Israeli Population: A Population Analysis for Anemia in 34512 Israeli Infants Aged 9 to 18 Months

Joseph Meyerovitch, MDa,b, Michael Sherf, MD, MPHa,c, Felice Antebi, MBSa, Marie Barhoum-Noufi, MDd, Zeev Horev, MDe, Lutfi Jaber, MDf, Dorit Weiss, RN, PhDg and Ariel Koren, MDh

a Research and Health Planning Department, Health Planning and Policy Division
d Pediatric Health Center, Nazareth District
e Community Medical Division
g Community Nursing Division, Clalit Health Services, Tel Aviv, Israel
b Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel
c Department of Family Medicine, Ben-Gurion University, Beer-Sheva, Israel
f Neurology Clinic, Schneider Children's Medical Center of Israel, Tel Aviv University and Bridge to Peace Community, Tel Aviv, Israel
h Pediatric Hematology Unit and Pediatric Department B, Ha'Emek Medical Center, Afula and the Ruth and Baruch Rapapport School of Medicine, Technion, Haifa, Israel

OBJECTIVES. The purpose of this work was to use the comprehensive computerized database of Clalit Health Services to analyze the prevalence and contributing factors of anemia among the population of Clalit Health Services-insured Israeli infants aged 9 to 18 months, characterized by ethnic sector.

METHODS. This was a cross-sectional retrospective study for the year 2003 using the computerized database of Clalit Health Services for 34512 infants aged 9 to 18 months insured by the Clalit Health Services sick fund. Children with abnormal white blood counts at the time of the hemoglobin test and with chronic diseases were excluded. The data were analyzed for age, infant hemoglobin level, ethnic origin, district distribution, type of clinic where the infant received treatment, the number of iron prescriptions dispensed to each child, and the mother's last hemoglobin level before giving birth. Anemia was defined as a hemoglobin level <105 g/L.

RESULTS. The prevalence of anemia among Israeli infants is 15.5%. The prevalence is significantly higher in the non-Jewish population (22.5%) as compared with the Jewish population (10.5%). The lowest prevalence of anemia was found in pediatric health centers (10.7%). A significant correlation was found between the presence of anemia in infants and the presence of anemia found in their mothers. Infants with anemia used significantly less iron preparations.

CONCLUSIONS. This study is one of the first studies to use a comprehensive computerized database to perform a population-based analysis of anemic infants. We found a considerable percentage of infants to be anemic and identified a specific population to be at high risk for anemia. We describe 2 factors that have the potential to be altered through intervention: improving compliance of iron intake and maternal anemia. Major national efforts should be made to minimize the prevalence of anemia, especially in the non-Jewish population, and to learn more about the causes of iron-deficiency anemia in this group. This study provides a base for an intervention study.

Key Words: iron deficiency • anemia • medical computerized database • infancy

Abbreviations: CHS—Clalit Health Services • IDA—iron-deficiency anemia

Accepted Apr 24, 2006.


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