الفهرس 
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Abstract
Nutritional anemia refers to a condition in which Haemoglobin (Hb) content of the blood is lower than normal as a result of deficiency of one or more of the essential nutrients mainly iron, folic acid and vit B12. Iron Deficiency Anemia (IDA), is the most prevalent anemia in the world. It is a problem of serious public health significant, given its impact on psychological and physical development, behavior and work capacity. Adolescents have been found to have the highest prevalence of an unsatisfactory nutritional status of all age groups. The study was conducted to fulfill the following aims: 1- To study the magnitude of nutritional anemia determining the extent among school adolescents (11-18 years) in Alexandria & describe the distribution. 2- To study the epidemiologic factors & possible determinants related to anemia with emphasis on its socio-cultural, behavioral, biological and environmental aspects. 3- To identify the health services available to adolescent students in Alexandria. 4- To compare two group: one receiving iron supplement & the other without supplement. The study was conducted in three parts: The first part of the study was done using a cross-sectional approach. A total 983 school adolescent were selected from the 6 educational districts by the proportional allocation technique. A multistage stratified random sample method was used. Stratification took into consideration males / females, urban / rural , governmental / private, preparatory, secondary, technical, Azhaire schools. Study tools: - The first part of the study carried using the following methods: 1- Interviewing questionnaire: Completed with students, it included personal & socioeconomic data, health and dietary habits, pubertal history, medical history, utilized health services. 2- Clinical examination: Pulse rate was calculated, signs related to anemia were inspected. 3- Anthropmetric measurement: The weight and height were recording according to procedure of Jellife. 4- School records: Scholastic achievement was measured by recording the results of the mid-year examination 5- Dietary intake: It was done on a subsample of 202 students, the 24 hour recall method was used. 6- Laboratory Investigations: - Hb estimation was done for all students using cyanmethaemoglobin method, WHO criteria were used for identification and classification of anemic cases. - Haemtocrit was done for a subsample of the students. - Stool examination was done using simple sedimentation technique. - The second part of the study (intervention) : Thirty anemic cases were detected after screening of 75 school adolescent in a semiurban area. For each anemic case a matched anemic control of the same age, sex was selected from the cross- sectional part of the study, (who seek treatment by ordinary ways). Components of the intervention program: 1- Educational sessions were done: to make adolescents understand meaning, causes, clinical picture, complication, prevention and control of anemia. 2- Iron supplementation: Each anemic student was given fumiron plus capsules and instructed about the dose which was one capsule daily for 3 months . They were instructed to mark on a calendar (given to them) each day of taking iron capsules. 3- Deworming: Each case received deworming drug (antivar). Two tablets per day for 3 days. At the end of the intervention period Hb estimation was repeated.. -The third part of the study was identificantion of school health services available to adolescents: This part of the study was determined from the administrative sector of HIO. This was carried out by reviewing the concerned laws and regulations for school students (133) and interviewing key personnel (134) The study revealed the following main results: 1- The overall prevalence of anemia among school adolescents was 52.7^l