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Research Article: MENA Delphi consensus on iron deficiency anemia in infants and young children: screening, management, and prevention strategies

Date Published: 2026-08-07

Abstract:
Iron deficiency anemia (IDA) is one of the most prevalent and consequential nutritional disorders affecting infants and young children globally, with profound implications for neuro development and long-term health. Despite its well-documented risks, IDA remains under diagnosed and under treated, particularly in the Middle East and North Africa (MENA) region, where prevalence ranges from 23.2% in the UAE to 72% in Jordan. To address gaps in screening, diagnosis, and management, a multidisciplinary panel of 14 pediatric experts from nine MENA countries convened to develop evidence-based consensus recommendations. The methodology included a structured literature review, virtual consensus meetings, and iterative Delphi-style voting on 32 evidence-based statements across five domains: (1) prevalence and burden, (2) screening and diagnosis, (3) nutritional prevention, (4) treatment, and (5) public health strategies. Key recommendations included universal screening at 9–12 months using hemoglobin, CRP, and ferritin; first-line oral iron therapy (3–6 mg/kg/day of elemental iron for 3–6 months); and avoidance of cow’s milk before 12 months. The panel also developed a comprehensive algorithm to standardize diagnosis and management across the region. Major barriers identified were underutilized screening practices (85.71% agreement) and insufficient public awareness (92.86% emphasized tailored campaigns). Excessive and early cow’s milk consumption was considered a key dietary contributor to IDA, with 84.6% agreement on its role due to low iron content and 69.2% agreement on its inhibitory effects on iron absorption and risk of gastrointestinal blood loss. This consensus highlights critical interventions, including iron-rich complementary feeding, caregiver education, and referral for refractory cases. By aligning clinical practice with current evidence and regional realities, these consensus recommendations provide a structured framework to reduce the burden of IDA in MENA through early detection, standardized care, and collaborative public health strategies.

Introduction:
Iron deficiency anemia (IDA) is one of the most prevalent and consequential nutritional disorders affecting infants and young children globally, with profound implications for neuro development and long-term health. Despite its well-documented risks, IDA remains under diagnosed and under treated, particularly in the Middle East and North Africa (MENA) region, where prevalence ranges from 23.2% in the UAE to 72% in Jordan. To address gaps in screening, diagnosis, and management, a multidisciplinary panel of 14…

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