Chemotherapy of malaria , Chemotherapy of malaria , مرکز فناوری اطلاعات و اطلاع رسانی کشاورزی
Nutritional anaemia is recognized as a major public health problem throughout the world, especially in developing countries. Infants, young children, menstruating women and, in particular, pregnant women are most frequently affected. Sufficient evidence suggests that iron deficiency is the most common cause of nutritional anaemia in the world. Folate deficiency is considered as the second most common cause. In this chapter we discuss the factors determining nutritional inadequacy in iron and folate requirements versus iron and folate intake, particularly in different age/sex categories; the amounts of iron and folate involved in daily exchange and the role of the diet and physiological and pathological variations in losses and requirements are reviewed. The consequences in terms of health of iron and folate deficiencies and methods for assessing iron and folate status of populations are also presented.
The Eighth Joint Expert Committee on Nutrition of FAO and WHO1 emphasized the need for an accepted classification and definition of protein-calorie malnutrition. There are two pressing reasons for this. Bengoa* summarized the available information about the frequency of protein-calorie malnutrition in different countries. There are many gaps, partly because for some countries there are no data, and partly because data which do exist are not always comparable. It is important that studies of prevalence should be extended and that the same criteria should be used everywhere. Secondly, the prevailing pattern of malnutrition in any region may give some information about the nature of the dietary deficiency and so will have a bearing on the preventive measures which are most appropriate. There are two schools of thought about this. According to what might now be called the classical theory, kwashiorkor results from a deficiency of protein with a relatively adequate energy supply, whereas marasmus is caused by an overall deficiency of energy and protein. From this it follows that where the kwashiorkor syndrome prevails, protein rich supplements would be an appropriate method of prevention. On the other hand, Gopalan and his co-workers* produced evidence that there are no quantitative or qualitative differences in the diets of children who subsequendy develop kwashiorkor or marasmus. They therefore proposed that the difference in the clinical picture reflects not a difference in diet but a difference in the capacity of the child to adapt. Whichever of these theories is correct the fact remains that according to reports in the literature the prevailing pattern does differ from one country to another.4 If the differences are real there must be some reason for them, and the first step in finding the reason is to put the observations on a firm foundation with an agreed system of classification. The need for this is urgent because an alteration in the pattern of protein-calorie malnutrition and in its age of onset has important implications for the planning of preventive policies.
