Modern trends in the prevention and treatment of iron‑deficiency anemia in children and mothers using nanotechnology

Abstract

 Introduction. The problem of iron‑deficiency anemia (IDA) among children and mothers in the Republic of Uzbekistan is one of the priority areas of healthcare, and measures to reduce anemia are included in the state program “Strategy for the Country’s Development until 2030”. The prevalence of anemia among children and mothers in the Republic of Uzbekistan has been steadily declining over the past 30 years — from 60–61 % to 20–15 % — thanks to national mass prevention programs that include fortifying wheat flour with micronutrients, providing weekly iron and folic acid supplementation to high‑risk groups, implementing WHO recommendations on healthy nutrition, and comprehensively informing healthcare workers and the population about anemia. In recent years, oral ferrotherapy with liposomal iron preparations based on nanotechnology has been widely implemented in the republic for the treatment and prevention of iron deficiency anemia. The aim of the study is to examine and evaluate the efficacy, safety, and tolerability of liposomal iron preparations based on nanotechnology in the treatment of IDA of varying severity in children and mothers in an outpatient setting, and to develop recommendations for the early diagnosis and correction of iron deficiency. Materials and methods. The materials for this prospective study included 40 children aged 1 to 5 years with mild, moderate, and severe anemia, and 42 mothers aged 22 to 49 years with diagnosed mild and moderate IDA. The children and mothers were undergoing outpatient treatment with a hematologist. The clinical, laboratory, and biochemical parameters of IDA were studied before and after ferrotherapy, and the efficacy, safety, and tolerability of liposomal iron preparations for children (Liposemi drops) and adults (Liposemi Plus, capsules), based on nanotechnology, were assessed. Results and their discussion. Among all children, hemoglobin levels increased on average from 90.7 ± 0.45 g/L to 105.53 ± 0.76 g/L (P < 0.01). In the group of children with mild anemia, the increase in hemoglobin was 21.21 g/L; in the group of children with moderate anemia, it was 25.83 g/L; and in the group of children with severe anemia, it was 34.33 g/L. Ferritin levels in general increased from 3.1 ± 1.38 µg/L to 12.22 ± 1.18 µg/L (P < 0.01) in all children. Among mothers, a significant increase in hemoglobin was shown from 84.95 ± 4.4 g/L to 103.6 ± 5.4 g/L, and in the number of red blood cells from 3.6 ± 0.07 million to 3.9 ± 0.08 million (P < 0.01). Serum iron levels also increased significantly, from 21.2±0.85 to 25.21±0.85 µmol/L, and ferritin levels increased from 112.5±6.4 µg/L to 129.4±5.7 µg/L (P<0.01). Transferrin levels decreased significantly, from 3.52±0.07 to 3.03±0.09 g/L (P<0.05). Conclusion. Ferrotherapy for IDA in children and mothers using liposomal iron preparations “Liposemi Drops” and “Liposemi Plus” is an effective method of treating IDA; it has high bioavailability, safety, good tolerability, and a minimal percentage of side effects (2.2%). The more severe the degree of anemia, the higher the increase in hemoglobin. The research results obtained allow us to recommend liposomal iron preparations for ferrotherapy not only for patients with IDA, but also for patients with anemia associated with chronic diseases combined with IDA, including patients with chronic diseases of the gastrointestinal tract.