Abstract:
Anemia is a major health issue all over the world. It is a condition in which you lack enough red blood cells to carry adequate oxygen to your body’s tissues. Growth retardation, decreased motor and cognitive development, as well as increased morbidity and death, have all been linked to it. From April 21 to June 21, 2022, and institutional-based cross-sectional study design will be used. In this study, we’ll analyze the rate of anemia among children visiting the OPD Department of Pediatrics and as well as admitted patients in Ward 19 and 20. A pretested structured questionnaire will be used to collect data. By using descriptive statistics the data will be analyzed. The goal of this study will be to determine the prevalence of anemia and its associated factors among children who’ll visit Nishtar Medical Hospital in Multan. Dietary interventions will be effective in improving anemia in children especially, the type iron deficiency anemia.
Introduction
Prevalence of anemia:

Prevalence of anemia in Pakistan
Anemia is known a term that usually occurs when the level of red blood cells (RBCs) decreases or there is a decrease in hemoglobin (Hb) (King, 2007) . The condition during which hemoglobin (HB) concentration is lower than normal and the number of red blood cells (RBCs) is less than normal and is inadequate to persuade the physical needs of individuals. (WHO, 2013). Approximately, thrice of the population of the world is affected. It is connected to an increase in the rate of morbidity and mortality in females of older age and infants, low birth outcomes, and impaired mental performance among adults (Haider et al., 2013). Infants and reproductive-age women are especially affected.
Anemia is a common problem among children. In the US, 20 percent of the children will be recognized with anemia hereafter in their lives. Anemia affects toddlers who don’t have enough red blood cells or hemoglobin. Hemoglobin is a type of protein in the human body that allows red blood cell’s to transport oxygen and other substances to other cells or organs. It is important to understand that there are several types and classifications of anemia. Anemia is often caused by a variety of issues with the red blood cells (Mukherjee and Ghosh, 2012). Below we will discuss some types of Anemia.
Iron-deficiency anemia: Iron is an essential element that is required by the human body for a variety of functions, especially for the synthesis of hemoglobin. A condition known as iron deficiency anemia refers to when there is too little iron in the bloodstream (Harper et al., 2015).
Another type of anemia is Pernicious Anemia: which is another most common type of anemia that can cause vitamin B12 deficiency. Without Vitamin B12 life is impossible. In order for the body to make new blood cells, such as numbers of new RBCs formed in the body every day so it needs iron (Turner and Talbot, 2009).
Hemolytic anemia
There is also a type of anemia known as hemolytic anemia, it is also another type of anemia, in this red blood cells are demolished and eliminated from the body before they reached towards their normal life expectancy. (Natasha and Yasmin, 2010).
Thalassemia
The next type is Thalassemia: Which is an inborn disorder of the blood that ends up in fewer healthy RBCs and low hemoglobin level in the body.
Sickle Cell Anemia
In addition, another type of anemia exists called Sickle Cell Anemia. In this case, the body produces red blood cells of curved shape (C form). This is typically identified by a lower hematocrit value or a less Hb concentration (Schrier, 2018), however, it can also be determined by an RBC count, blood reticulocyte count, mean corpuscular volume, Hb electrophoresis, or blood smear analysis. Anemia 14 is determined primarily by Hb concentration, which is the most common marker used in hematology evaluation. Your body will usually get enough iron from a normal, balanced diet. Despite low dietary intakes of iron, folate, and foodstuffs that usually help in the absorption of iron, low bioavailability of iron is the biggest cause of anemia ( Prema, 1989 and 1992). In the absence of sufficient iron stores at birth (Kilbridge et al., 1999), a low amount of iron in mother’s milk, as well as low dietary iron intake that remains low throughout neonates and childhood, result in anemia being more prevalent in children (Toteja & Singh, 2004; Kapur et al., 2002).
The reason will differ depending on whether the anemia is hyperproliferative (when the corrected reticulocyte count is less than 2%) or hyperproliferative (when the corrected reticulocyte count is lesser than 2%).
Microcytic anemia (MCV 80 fl) and normocytic anemia (MCV 80-100 fl) are two types of hyperproliferative anemia based on the mean corpuscular volume (Suzuki, 2015).
Anemia affected estimation:
Anemia affected an estimated 32.9 percent of the total world’s population in 2010. In 2016, two of the most endangered demographics to anemia were (1) children under the age of five (42%) and especially newborns and children under the age of two; (2) WRA (39%) and (3) pregnant women (46 percent ). Females are shown to be at higher risk for anemia than males in practically all geographic regions and throughout the majority of age groups. Other at-risk populations include the elderly because the prevalence of anemia increases with age in people over 50, however, data on this is limited (Patel, 2008).
Leaving anemia untreated or undiagnosed over an extensive time period will result in multi-organ disorders and even death. An anemic pregnant woman can give birth to a baby with a low birth weight if she goes into premature labor (O’Farril-Santoscoy et al., 2013). Multiple comorbidities are more prevalent in the older population (Triscott, 2015). Chronic anemia is most commonly associated with cardiovascular problems. Complications of myocardial infarction include angina, and high output heart failure, and myocardial infarction.
Treatment of anemia in children:

Treatment of anemia in children
Anemia can be treated in a variety of ways. Each way can increase the number of RBCs, which increases oxygen levels in the blood. Here is a list of treatments:
Iron-deficiency anemia: It is useful to change your diet and supplement iron when it is possible, your medical expert will recognize and prescribe the reason for too much bleeding.
Thalassemia: Supportive treatments may involve iron chelation, blood transfusions, folic acid supplements, and the transplantation of bone marrow in some cases.
Sickle Cell Anemia: The treatment for sickle cell anemia may include therapy of Oxygen, pain relievers, and IV fluids, but antibiotics, folate, transfusion of blood, and hydroxyurea, which kills cancerous cells may also be required.
Hemolytic anemia: immunosuppressive drugs, infection treatments, and plasmapheresis can be used as treatment options for this condition.
Vitamin deficiency anemia: In the treatment of this anemia some dietary supplements and injection of vitamin B12 are required. Anemia treatment regimens frequently include dietary adjustments. Iron-rich foods and vitamins important for hemoglobin and red blood cell synthesis should be included in anemia diet programs. Foods that absorb iron should also be provided. Iron foods come in two forms: heme iron and non-heme iron. Men should consume 10 milligrams of iron daily, and women should consume 12 milligrams. The iron required for anemia treatment varies by person, but most require 150 to 200 mg daily. Anemia may be caused by nutritional deficiencies, so eating foods high in iron can help. Foods that contain iron include cereals fortified with iron, and leafy green vegetables, such as lentils, spinach, and beans while other sources are brown rice, red meats, fish, kale, nuts and seeds, and eggs. The most common form of anemia among young children and adolescents is iron-deficiency anemia. Over a third of anemia is caused by folate or vitamin B12 deficiency. Iron and folate supplementation programs should be strengthened, as well as prevention of folate or vitamin B12 deficiency anemia (Lam, 2020). If Iron-rich foods are provided to infants and breastfeeding mothers also consume them in their diet then it will reduce the status of iron deficiency anemia. So we will recommend dietary management and food supplementations to reduce the rate of iron deficiency anemia.
The goal of the study is to check the prevalence of anemia in the children aged up to 14 years in paeds wards of Nishtar Hospital Multan. Hence the overall objective of this investigation is to measure the prevalence and determinants of anemia among children in Nishtar Hospital.