Diagnosing and treating anemia in rural Guatemala

Phase 2 of the Lucky Iron Fish Project is complete. Returning to the villages where iron screenings were held last year (March 2016), we were able to retest iron status among those given a Lucky Iron Fish. Unfortunately, one village did not return for testing because it was rumored that the Lucky Iron Fish had “bad spirits” and subsequently discarded it. Therefore, our study population was reduced to approximately 140 individuals who had impaired iron status and were given a Lucky Iron Fish (March 2016, Phase 1). Approximately 60 people (43%) returned (March 2017) to be retested after using their Lucky Iron Fish for a period of 1 year. Although we have not completed our statistical analyses, it appears that those using the Lucky Iron Fish regularly (at least 4 times/week) had improved iron status. At least 80% of those retested and improved iron values. Our next report will include a detailed statistical analysis, which will provide a full examination of change between pre- and post-iron indices (hemoglobin and hematocrit).

In addition to our follow-up from last year, iron screenings were held at 5 new villages. Approximately 60 people (out of 400 that were tested) had impaired iron status, and were given a Lucky Iron Fish. Although we will not be conducting a follow-up study on these individuals, it is our goal to monitor iron deficiency anemia in Guatemala and to create an “anemia map” of the country to identify communities and populations at greatest risk. In addition to iron status, we also screened for impaired blood glucose regulation (type 2 diabetes). Obesity and impaired blood glucose regulation are emerging health problems in developing countries such as Guatemala. This was accomplished by measuring A1c values, which provides an accurate assessment of blood glucose regulation over time. The advantage of measuring A1c vs. blood glucose is that fasting is not required and the measure reflects average blood glucose over the previous 3 months (rather than 1 point in time). Interestingly, communities located in close proximity to food stores tended to have a lower incidence of impaired iron status, but a higher occurrence of impaired blood glucose. We attributed this to the increased availability and consumption of processed foods and sugar-sweetened beverages.

The students on the 10-day medical mission were amazing. Not only did these hard working, dedicated individuals provide the assistance needed to conduct a project of this magnitude, they were an absolute pleasure to be with. A journalism student (Garrett R. Kalt, Murrow College, backpack journalist) wrote an article about the project, which was published in WSU news (see URL below). As a group, the students all contributed to a fund that was used to sponsor a child's educational expenses until the age of 18 (y). Sponsorship covers the cost of books and a school uniform. Other exciting news is that is this project was selected to receive the Outstanding Achievement Award in International Activities by the Washington State University, College of Arts and Science. 

https://cas.wsu.edu/welcome/cas-awards-and.../2017-recipients/

Your generous contributions go directly to funding this project. We greatly appreciate the financial support we have received. Yearly expenses total approximately $3000, and without this  we would not be able to keep this project going. Thank you.

https://news.wsu.edu/2017/05/23/iron-blood-levels-guatemala/

Links:

• Article published in WSU news
• Outstanding Achievement in International Activities

Ana Maria and I leave for Guatemala TODAY! After a great deal of packing, packing, packing, and packing, we are ready to go. Our 25 suitcases (along with our 25 students) contain medical supplies, equipment, 300 pounds of split peas (for distribution to families), hundreds of toothbrush/toothpaste), stuffed animals, clothing, shoes, etc. Oh, and most importantly 200 Lucky Iron FIsh for distribution to those with impaired iron status. There is so much planning that goes into these trips. First, on our agenda is to visit the 4 villages that we went to last year to retest iron status of those given a Lucky Iron Fish (see previous reports). Over the next two weeks, we will then travel to 5 new villages. The dentists will be busy extracting decayed teeth, while we are busy screening for iron deficiency anemia. The time goes fast, and we work very hard; our students are amazing. We want to thank everyone who has made a financial contribution to this project. It takes about $2000. per year to keep this program sustainable, and we could not do it without your support. I will submit an update when we return and let you know more about our trip.  A few photos below of the group (2017 HIM/WSU students).

Best,

Kathy and Ana Maria

(and our wonderful 25 students from Washington State University)