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Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study

OBJECTIVE: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary healthcare to 2.2 million Palestinian refugees in Jordan. This study aimed to measure patient and doctor adherence to the UNRWA guidelines for the prevention and treatment of iron d...

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Autores principales: Harada, Yuriko, Kishk, Nada Abu, Hajat, Shakoor, Akita, Mio, Horino, Masako, Albaik, Shatha, Naqera, Khalil Abu, Hababeh, Majed, Habash, Rami, Seita, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8889312/
https://www.ncbi.nlm.nih.gov/pubmed/35232788
http://dx.doi.org/10.1136/bmjopen-2021-056490
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author Harada, Yuriko
Kishk, Nada Abu
Hajat, Shakoor
Akita, Mio
Horino, Masako
Albaik, Shatha
Naqera, Khalil Abu
Hababeh, Majed
Habash, Rami
Seita, Akihiro
author_facet Harada, Yuriko
Kishk, Nada Abu
Hajat, Shakoor
Akita, Mio
Horino, Masako
Albaik, Shatha
Naqera, Khalil Abu
Hababeh, Majed
Habash, Rami
Seita, Akihiro
author_sort Harada, Yuriko
collection PubMed
description OBJECTIVE: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary healthcare to 2.2 million Palestinian refugees in Jordan. This study aimed to measure patient and doctor adherence to the UNRWA guidelines for the prevention and treatment of iron deficiency anaemia in moderate to severe anaemia children, defined as haemoglobin (Hb) level <10.0 g/L. DESIGN, SETTING AND PARTICIPANTS: A retrospective observational study was conducted by analysing the electronic health records of 717 children (353 boys and 364 girls) children aged 12 months old in 2018 in the Jerash Camp Health Centre, Jordan. OUTCOME: Patient adherence to the UNRWA guidelines was calculated by the proportion of health centre visits and doctor adherence by the proportions of Hb tests and iron supplementation among moderate to severe anaemia children at screening, first, second and third follow-up visits, respectively using STATA. RESULTS: The prevalence of moderate to severe anaemia was 15.6% among 12-month-old children. After 1 month of iron supplementation, 83.7% of anaemic children improved their Hb status: mean [Formula: see text] SD from 9.1 [Formula: see text] 0.6 g/L to 10.1 [Formula: see text] 1.0 g/L. Patient and doctor adherence to the UNRWA guidelines was above 80% at the screening visit but progressively decreased at follow-up visits, especially patient adherence at the third follow-up visit of 34.4%. The analysis revealed unnecessary health centre visits and iron supplementation being given to mildly anaemic children (Hb level=10.0 g/L–10.9 g/L). Additionally, children visited the health centre at an age significantly later compared with that recommended by the UNRWA guidelines for the screening, first and second follow-up visits (p-value<0.05). CONCLUSION: Adherence to the UNRWA guidelines was above 80% at screening but much lower at follow-up visits. Urgent action is needed to improve adherence at follow-up visits and to minimise any unnecessary health centre visits and iron supplementation to mildly anaemic children.
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spelling pubmed-88893122022-03-17 Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study Harada, Yuriko Kishk, Nada Abu Hajat, Shakoor Akita, Mio Horino, Masako Albaik, Shatha Naqera, Khalil Abu Hababeh, Majed Habash, Rami Seita, Akihiro BMJ Open Nutrition and Metabolism OBJECTIVE: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary healthcare to 2.2 million Palestinian refugees in Jordan. This study aimed to measure patient and doctor adherence to the UNRWA guidelines for the prevention and treatment of iron deficiency anaemia in moderate to severe anaemia children, defined as haemoglobin (Hb) level <10.0 g/L. DESIGN, SETTING AND PARTICIPANTS: A retrospective observational study was conducted by analysing the electronic health records of 717 children (353 boys and 364 girls) children aged 12 months old in 2018 in the Jerash Camp Health Centre, Jordan. OUTCOME: Patient adherence to the UNRWA guidelines was calculated by the proportion of health centre visits and doctor adherence by the proportions of Hb tests and iron supplementation among moderate to severe anaemia children at screening, first, second and third follow-up visits, respectively using STATA. RESULTS: The prevalence of moderate to severe anaemia was 15.6% among 12-month-old children. After 1 month of iron supplementation, 83.7% of anaemic children improved their Hb status: mean [Formula: see text] SD from 9.1 [Formula: see text] 0.6 g/L to 10.1 [Formula: see text] 1.0 g/L. Patient and doctor adherence to the UNRWA guidelines was above 80% at the screening visit but progressively decreased at follow-up visits, especially patient adherence at the third follow-up visit of 34.4%. The analysis revealed unnecessary health centre visits and iron supplementation being given to mildly anaemic children (Hb level=10.0 g/L–10.9 g/L). Additionally, children visited the health centre at an age significantly later compared with that recommended by the UNRWA guidelines for the screening, first and second follow-up visits (p-value<0.05). CONCLUSION: Adherence to the UNRWA guidelines was above 80% at screening but much lower at follow-up visits. Urgent action is needed to improve adherence at follow-up visits and to minimise any unnecessary health centre visits and iron supplementation to mildly anaemic children. BMJ Publishing Group 2022-03-01 /pmc/articles/PMC8889312/ /pubmed/35232788 http://dx.doi.org/10.1136/bmjopen-2021-056490 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Nutrition and Metabolism
Harada, Yuriko
Kishk, Nada Abu
Hajat, Shakoor
Akita, Mio
Horino, Masako
Albaik, Shatha
Naqera, Khalil Abu
Hababeh, Majed
Habash, Rami
Seita, Akihiro
Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title_full Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title_fullStr Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title_full_unstemmed Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title_short Adherence to UNRWA’s anaemia treatment guidelines in the Jerash Camp Health Centre, Jordan: a retrospective observational study
title_sort adherence to unrwa’s anaemia treatment guidelines in the jerash camp health centre, jordan: a retrospective observational study
topic Nutrition and Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8889312/
https://www.ncbi.nlm.nih.gov/pubmed/35232788
http://dx.doi.org/10.1136/bmjopen-2021-056490
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