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Revista Brasileira de Hematologia e Hemoterapia

Print version ISSN 1516-8484

Rev. Bras. Hematol. Hemoter. vol.36 no.2 São José do Rio Preto Mar./Apr. 2014 

Scientific Comments

Comments on: iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza Strip, Palestine

Mohammad E. Shubair* 

1Palestinian Health Research Council, and the Islamic University of Gaza, Gaza, Palestine

The last issue of the Revista Brasileira de Hematologia e Hemoterapia included a scientific report presented by Sirdah et al.1 which focuses on the occurrence of iron deficiency anemia (IDA) among less-fortunate children living in marginalized areas of the Gaza Strip in Palestine. Successive reports from international organizations interested in the health and well-being of people, such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), still consider iron deficiency and its related anemia as a challenging nutritional health problem that significantly afflicts individuals of all ages and economic groups in developing as well as in developed countries.2,3 However, the magnitude of the problem is intensified when the risk factors for developing IDA coexist in vulnerable populations like those living in remote and marginalized areas4,5 where health related services are limited or totally absent 6 and the economic situation is not satisfactory.7

The study of Sirdah et at. aimed to estimate the prevalence and identify possible risk factors of IDA among kindergarten children living in the marginalized areas of the Gaza Strip, and to evaluate the effectiveness of supplementation with an oral iron formula. The authors randomly screened 745 kindergarten children (384 male and 351 female) living in nine areas classified by the local organizations as marginalized and less fortunate for development. The authors used univariate analysis and constructed a multiple logistic regression model in order to identify potential risk factors for developing IDA in the children.

The screening stage of the study stressed the occurrence; one-third of kindergarten children of the marginalized areas suffered from iron deficiency anemia and identified possible risk factors for developing IDA. However, the authors did not assess parasitic infections in those children which is one of the factors that causes anemia in early childhood.7,8 Luckily, iron supplementation for three months ameliorated their anemic status and normalized the markers of iron deficiency in the anemic children.

From the national point of view and as chairman of the Palestinian Health Research Council (PHRC), we aim to promote the sustainable development of the Palestinian health system by coordinating, regulating, funding and supporting health research in Palestine thus providing credible information for decision making, policy setting and health measures that reflect the reality and the challenges of the Palestinian situation. Therefore, the results of the study of Sirdah et al. are of great interest to the PHRC, since they justify the necessity for government and nongovernment intervention to correct the health services in these marginalized areas. Moreover, we encourage other researchers and organizations to conduct other large-scale studies that address and monitor the nutritional status as well as other communicable and non-communicable diseases affecting the people in these marginalized areas, especially in high-risk groups.


Sirdah MM, Yaghi A, Yaghi AR. Iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza strip, Palestine. Rev Bras Hematol Hemoter. 2014;36:132-8. [ Links ]

World Health Organization /UNICEF/UNU. Iron Deficiency Anaemia: Assessment, Prevention, and Control. A Guide for Programme Managers. Geneva, Switzerland: World Health Organization; 2001. [ Links ]

Centers for Disease Control and Prevention. Iron deficiency - United States, 1999-2000. MMWR Morb Mortal Wkly Rep. 2002;51:897-9. [ Links ]

Monárrez-Espino J, Martínez H, Martínez V, Greiner T. Nutritional status of indigenous children at boarding schools in northern Mexico. Eur J Clin Nutr. 2004;58:532-40. [ Links ]

Fielding JR. Diagnosis of iron deficiency and anaemia of chronic disease. Aust J Med Sci. 2013;34:2-13. [ Links ]

Christofides A, Schauer C, Zlotkin SH. Iron deficiency anemia among children: Addressing a global public health problem within a Canadian context. Paediatr Child Health. 2005;10:597-601. [ Links ]

Ngui R, Lim YA, Chong Kin L, Sek Chuen C, Jaffar S. Association between anaemia, iron deficiency anaemia, neglected parasitic infections and socioeconomic factors in rural children of West Malaysia. PLoS Negl Trop Dis. 2012;6:e1550. [ Links ]

Shubair ME, Yassin MM, al-Hindi AI, al-Wahaidi AA, Jadallah SY, Abu Shaaban N al-D. Intestinal parasites in relation to hemoglobin level and nutritional status of school children in Gaza. J Egypt Soc Parasitol. 2000;30:365-75. [ Links ]

See paper by Sirdah MM et al. on pages 132-8.

*Corresponding author at: Islamic University of Gaza Jamal Abdel Naser Street P.O. Box 108 Gaza, Palestine E-mail address: (M. E. Shubair)

Conflicts of interest The author declares no conflicts of interest.

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