An assessment for diagnostic and therapeutic modalities for management of pediatric Iron defficiency Anemia in Saudi Arabia: a cross-sectional study

Author(s): Hadi Jaber Al Sulayyim

Introduction: Iron deficiency anemia (IDA) is a global public health issue that alter more than 2 billion individuals worldwide. Nevertheless, evidence for optimal management of IDA is lacking.

Methods: To evaluate the diagnostic criteria and therapeutic modalities for pediatric IDA employed by physicians in a major public healthcare facility in Riyadh, a validated questionnaire containing demographic data and patient case-scenarios associated to diagnosis and treatment of IDA was employed. Robust regression analysis was utilized to identify factors associated with overall score of participants.

Results: Of the 166 physicians surveyed 147(88.6%) were encompassed in the study. Wide variability was observed in IDA diagnosis and therapy practices. For nutritional IDA, only 15.6% suggested no other laboratory tests in addition to CBC. The majority favoured treatment with ferrous sulphate (77.6%) separated into two doses (57.1%), but the total daily elemental iron doses varied widely from 2 to 6 mg/kg. For intravenous iron, 42.9% suggested iron dextran, 32.7% iron sucrose, and 13.4% would continue oral iron. Of all measured factors, median score was significantly highest in pediatric hematologists compared together with pediatricians, family medicine specialists and GPs; p = 0.007, and those work in tertiary care compared with those individuals in primary care; p = 0.043. However, in multivariate robust regression analysis, overall score was only significantly associated with professional qualification [pediatric hematologist β = 13.71,95%CI 2.48– 24.95, p = 0.017; pediatrician β = 1.77,95%C (− 6.05–9.59, p = 0.66; family medicine β =2.66,95%CI-4.30-9.58, p = 0.45 equated with general practitioner].

Conclusion: Wide variations exist among physicians in diagnosis and treatment of pediatric IDA. Intervention programs and national guidelines are urgently needed.