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Abstract Summary Iron is vital for all living organisms because it is essential for multiple metabolic processes, including DNA synthesis and oxygen and electron transport. Iron deficiency is a main nutritional deficiency disorder affecting large fractions of the world population and is a common cause of anemia. Iron and other micronutrients have immune modulating functions that influence the susceptibility of a host to infectious diseases. It has been suggested that iron supplementation can improve iron levels and reduce morbidity from upper respiratory tract infections in children. The aim of this study was to assess the percentage and type of recurrent respiratory tract infection in Egyptian school children in shobra region and to assess the percentage of iron deficiency anemia and the outcome of iron supplementation on the recurrenc and severity of upper respiratory tract infection among them. In this study 1000 school students from 2 urban schools in Cairo was followed up for 3 months to select those had recurrent upper respiratory tract infections, 245 (24.5%) of the followed up Summary 13 8 children were suffering from recurrent URTIs in the first 3 month enrollment period. This study showed that the most prevalent upper respiratory tract infection during the enrollment period was common cold (60% of the total RURTIs) with a mean incidence rate 2 ± 0.63followed by acute tonsillitis (29% of the total RURTIs) with a mean incidence rate 0.96±0.36. In this study the percentage of iron deficiency anemia among children who experienced recurrent upper respiratory tract infections was 42.8%. In this study there was a high percentage of exposure to passive smoking (85.9%) among the three studied groups and the difference was not significant statistically. In this study there was a high percentage of high education among mothers and fathers of children in non anemic groups compared to mothers and fathers of children in the anemic group and the difference was highly significant. This study showed a highly significant statistical difference between the non anemic group (B) and the anemic group (A) as regards the percentage of consumption of the RDI of iron . Summary 13 9 In the anemic group after 3 months of daily iron intake of a dose of 6mg/kg/day, there was a higher mean hemoglobin, mean iron level in blood, mean ferritin level in blood and a lower mean total iron binding capacity after intervention in group A students compared to pre intervention mean and the difference was highly significant statistically. This study showed that there was a higher mean number of illnesses in group A compared to group B1 and group B2 at the first visit and the difference was highly significant statistically There was no significant difference statistically between the three studied groups as regards Common cold, acute tonsillitis, acute laryngitis, otitis media, Sick days with URTIs or absence days from school. This study showed that therapeutic iron supplementation to the anemic group and correcting the iron deficiency anemia There was lower mean number of illness, common cold, laryngitis and sick days in the iron supplemented groups (A, B1) than the non iron supplemented group (B2) either supplemental iron was given or not, but the difference was not significant statistically between the three groups as regards mean attacks of illness, attacks of common colds, otitis media, laryngitis, sick days or absence days in spring months. Summary 14 0 During subsequent visits There was a lower mean number of number of illnesses, common cold attacks, number of sick days and number of absence days in groups A, B1 compared to group B2 and the difference was significant statistically either supplemental iron was given or not. This study showed that there was no significant difference statistically between the three study groups as regards the mean CARIFS score in the enrollment period, this indicated that there was no significant difference statistically between the three study groups as regards the severity of their attacks at baseline. Later on in this study,treating the anemic patients by therapeutic dose of iron showed a higher mean CARIFS score in group A (anemic children) compared to groups B1 , B2 and the difference was highly significant statistically in visit 2 which indicated that the severity of URTIs was increased with high dose of iron supplementation. This study showed that there was a lower mean of CARIFS score in groups A, B1, compared to B2 in subsequent visits and the difference was highly significant statistically when supplemental iron was given and There was a lower mean CARIFS score in groups A and B1 compared to group B2 but the difference was not significant statistically when supplemental iron Summary 14 1 was not given, this indicated that maintenance dose of iron decreased the severity of URTIs. This study showed the least incidence rate of illnesses among group B1 followed by group A and the group with the highest incidence was group B2and incidence rate of the illness in group (B2) was 7 times higher than groupB1 at the last visit after intervention, and almost two times higher in B2 compared to group A although the incidence rate of illnesses was nearly the same at the start of the study. This study showed the highest rate of illnesses in the 3 groups occurred during the autumn and winter months |