Prevalence of Anemia and Iron Deficiency in Women of Reproductive Age in Cuba and Associated Factors.

This study aims to evaluate the prevalence of anemia and iron deficiency in women of reproductive age and the association with inflammation, global overweight, adiposity, and menorrhagia. A sample design of women of reproductive age from the Eastern, Central, and Havana Regions was carried out. Biochemical determinations of hemoglobin, serum ferritin, soluble transferrin receptors, leukocytes, C-reactive protein, alpha-1 acid glycoprotein, and homocysteine were performed. Serum ferritin was also adjusted by inflammation. Nutritional status was assessed, and menstrual characteristics were collected by survey. A total of 742 women were studied. The prevalence of anemia was 21.4%, iron storage deficiency at 16.0%, and erythropoietic dysfunction at 5.4%, with inflammation at 47.0% and elevated homocysteine at 18.6%. Global overweight was 46.2% and increased adiposity at 58.4%. Anemia is associated with iron deposition deficiency (OR = 3.023 (1.816-5.033)) and with erythropoietic deficiency (OR = 5.62 (3.03-10.39)), but not with inflammation, global overweight, and adiposity. Global overweight was found to be associated with inflammation (OR = 2.23 (1.41-3.53)). Anemia was associated with heavy menstrual bleeding (OR = 1.92 (1.34-2.76)). Homocysteine was associated with inflammation (OR = 2.05 (1.08-3.90)), but not with anemia. In conclusion, anemia in Cuba is classified as a moderate public health problem, but not iron deficiency. A high prevalence of overweight and obesity was found, associated with inflammation, but not with anemia or iron deficiency. Heavy menstrual bleeding is a factor associated with anemia.

[Impact of the actions for the sustainable elimination of iodine deficiency in Cuba]. / Impacto de las acciones para la eliminación sostenible de la deficiencia de yodo en Cuba.

OBJECTIVES: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. MATERIALS AND METHODS: A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. RESULTS: The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). CONCLUSIONS: The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.

Impacto de las acciones para la eliminación sostenible de la deficiencia de yodo en Cuba / Impact of the actions for the sustainable elimination of iodine deficiency in Cuba

Objetivos: Evaluar la efectividad del “Programa de Eliminación Sostenible de Deficiencia de Yodo” mediante determinación de yoduria y prevalencia de bocio. Materiales y métodos. Se realizó un estudio transversal en el cual se incluyó a la población escolar cubana de 6 a 11 años que cursaba estudios en el periodo 2011-2012. Se empleó un muestreo estratificado polietápico. En el cual se determinaron los niveles de excreción de yodo en la orina (yoduria) y la presencia de bocio. Resultados. La mediana de yoduria fue de 176,3 µg/L; el 7,6% de los escolares presentaron alguna deficiencia de yodo, solo el 2,2% estaba por debajo de 50 µg/L (deficiencia severa) y el 15,3% tenía yodurias por encima de 300 µg/L. El porcentaje de escolares con nutrición óptima de yodo fue de 43,5%, esta categoría presentó una frecuencia significativamente mayor ( p=0,03) en el estrato montaña (52,5%). La prevalencia de bocio encontrada fue de 17,6%, que corresponde a una endemia ligera. Sin embargo, en el estrato montaña se encontró una prevalencia de 32,6 % (endemia severa). Conclusiones. El análisis integral del impacto de las acciones de control de la deficiencia de yodo evaluado a través de la excreción urinaria de yodo y la prevalencia de bocio refleja que ha dejado de ser un problema de salud poblacional en los estratos urbano y rural de Cuba, atribuible a un adecuado proceso de yodación de la sal. Sin embargo, aún se observa una alta prevalencia de bocio en la zona de montaña de Cuba.

Objectives: To assess the effectiveness of the Sustainable Elimination of Iodine Deficiency Program through determination of urinary iodine and goiter prevalence. Materials and methods. A cross-sectional study was conducted in Cuban school children aged 6 to 11 years old in 2011-2012. A stratified multistage sample was used in which the levels of iodine excretion in urine (urinary iodine) and the presence of goiter were determined. Results. The median urinary iodine was 176.3 µg/L; 7.6% of the students showed some deficiency of iodine, only 2.2% were below 50 µg/L (severe deficiency), and 15.3% had urinary iodine above 300 µg/L. The percentage of school children with optimal iodine nutrition was 43.5%, this category showed a significantly higher frequency (p=0.03) in the mountain areas (52.5%). Goiter prevalence was 17.6% which corresponds to a mild endemic. However, in the mountain area the prevalence was 32.6% (severe endemic). Conclusions. The comprehensive analysis of the impact of iodine deficiency control measures assessed by urinary iodine excretion and goiter prevalence reflects that it is no longer a population health problem in urban and rural areas of Cuba, attributable to a proper process of salt iodization. Nevertheless, high goiter prevalence is still observed in the mountain area of Cuba.