الفهرس 
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Abstract
Anemia is a public health problem affecting both developing and developed countries all over the world, with the highest prevalence among infants aged 6months up to 2 years. Iron deficiency anemia is the most common cause of anemia in the world. It is a worldwide nutritional problem, affecting all age groups and all socio-economic levels of society. IDA is a common disease in Egypt, with a very high prevalence rate. The prevalence of anemia also tends to be high among children with cerebral palsy due to: lack of nutritional food intake, depending on staple diet, recurrent infections, and multiple drug intakes. Identification of infants, who are at risk for IDA is vital as it further impairs growth and psychomotor development, reduces physical activity and resistance to infection.
As there is no sufficient data in Egypt comparing the efficacy of different iron preparations in the treatment of iron deficiency anemia, this research was designed to discuss and compare the efficacy of different iron therapies to reach the best results.
The aim of this work was to improve the quality of care provided to children with cerebral palsy attending the Pediatric Neurology Outpatient Clinic of Alexandria University Children Hospital (AUCH) by assessment of the status of iron deficiency anemia among them and comparing between the efficacy of 30% iron saturated lactoferrin and iron polymaltose complex in the treatment of iron deficiency anemia in children with CP.
In order to achieve these objectives, 150 children with CP screened for IDA by CBC including blood morphology and indices. Further investigations including iron profile (Serum Iron, serum ferritin, TIBC) were done for patients with proven microcytic hypochromic anemia (70 children). The prevalence of IDA in the study among children with CP was 46.6%. The studied children aged from 1 year to 10 years with the diagnosis of CP, attending to Pediatric Neurology Outpatient Clinic of Alexandria University Children’s Hospital (AUCH) with iron deficiency anemia. Children with CP were randomly divided after fulfilling the inclusion criteria into two groups; (group 1: including 35 children put on iron polmaltose) and (group 2: including 35 on lactoferrin). During the current study, 2 children were excluded due to poor compliance and 2 children dropped out during the course of the study. Thus, primary outcome measures including analyses of biochemical indices of blood and anthropometric indices were obtained from 66 infants (32 children in iron polymaltose group and 34 children in lactoferrin group, respectively). Follow up of the cases after one month and documenting the improvement in iron deficiency anemia by doing a follow up of CBC and iron profile (Fe, Ferritin, TIBC) after the treatment and any adverse effects.
Demographic and socioeconomic data showed that more than 70% of cases were classified into very low and low as regard their socioeconomic status. Regarding the etiological classification of children with CP, post anoxia was the most common cause responsible for CP in this study (63.6%), based on GMFCS levels, level V was the most commonly encountered as it was found in 36.4% of studied children. As regard the topographic classification, (39.4 %) were spastic quadriplegic.
As regards to feeding history, the majority of the studied children were suffering from feeding problems like (choking on solid, choking on liquid, difficulty chewing food, difficulty sucking, difficulty feeding self, difficulty drinking from cup, losing food from mouth, using bottle after age of 2y, using nasogastric tube) and semisolid and liquid foods were the most common types of food in (51.6%) of cases.
As regards to distribution of CP cases according to anthropometric measurements, more than two-thirds of these children (70.0%) were moderate to severely underweight. Near half (47.0%) of the children were severely stunted and (25.8 %) children were moderately stunted. Moreover, (43.9%) of the children were moderately to severely wasted.
The results of the present study shows that the percentage of Hb and serum ferritin rise in lactoferrin group was significantly higher than those in iron polymaltose group with less side effects as regards the constipation after one month of treatment.