MÜLTECİ ÇOCUKLARDA B12 VİTAMİNİ EKSİKLİĞİ Vitamin B12 Deficiency in Refugee Children

OZET Amac: B12 vitamini eksikliginde ortaya cikan megaloblatik anemi ve noro-motor gelisim geriligi baslica morbidite nedenidir. Cocuklarda B12 eksikligi en sik nutrisyonel alim yetersizligine baglidir. Multeci cocuklar nutrisyonel eksiklige bagli B12, D vitamini yetersizligi ve anemi icin yuksek risk altindadir. Bu calismada farkli sikayetler ile hastanemize basvuran Turk cocuklarin yani sira Suriyeli multeci cocuklarin B12 degerlerini ve hematolojik parametrelerini degerlendirerek toplumun farkli gruplarinda B12 vitamin duzeylerini ve eksikligini belirlemeyi amacladik. Gerec ve Yontem: Calismaya Ocak –Temmuz 2018 tarihleri arasinda 0-17 yas arasinda hemogram ve B12 vitamin duzeyleri bakilan 81 Turkiye cumhuriyeti vatandasi 53 Suriye uyruklu multeci olmak uzere toplam 134 cocuk dahil edilerek yas, cinsiyet, uyruk ile ilgili verilerin yani sira hemogram sonuclari ve B12 vitamin duzeyleri ile ilgili verileri hastane otomasyon sisteminden geriye donuk olarak alindi. Elde edilen veriler istatiksel olarak incelendi. Bulgular: Turk cocuklarin ortalama B12 duzeyi (336.6 pg/ml ) Suriyeli cocuklarin ortalama B12 duzeyine (271 pg/ml) gore daha yuksek bulundu (p=0.004). Turk cocuklarin % 16 (n=13)’ sinda B12 duzeyleri 200 pg/ ml’nin altinda, %31 (n=25)’inde 200-300 pg/ml arasinda, Suriyeli cocuklarin % 30 (n=16)’unda B12 duzeyleri 200 pg/ml’nin altinda, %45 (n=24)’inde 200-300 pg/ml arasinda saptandi. Turk cocuklarin hematokrit (Hct) degerlerinin (36.6±2.9) Suriyeli multeci gruptan (34.6±4.8) anlamli olarak yuksek oldugu saptandi (p=0.04). Sonuc: Multeci cocuklar saglikli besinlere ulasimdaki zorluklar nedeniyle yeterli ve dengeli beslenme sorunlari ile karsi karsiya kalmaktadirlar. Bu cocuklarin buyume gelisimlerini saglikli bir sekilde surdurebilmeleri icin beslenme desteginin saglanmasi basta olmak uzere gerekli tum tedbirlerin alinmasi hayati oneme sahiptir. Anahtar kelimeler: B12 vitamini; Cocuk; Multeci ABSTRACT Aim: The most common morbidities seen with vitamin B12 deficiency in children are megaloblastic anemia and retarded neuro-motor development. B12 deficiency in children is mostly due to insufficient nutritional intake. Immigrant children are especially under a high risk of developing Vitamin D deficiency, B12 deficiency and anemia due to undernutrition. In this study, our main objective was to compare B12 levels and hematologic parameters of Turkish children with Syrian refugee children and to evaluate Vitamin B12 levels and deficiencies in different groups of society. Materials and Methods: The study included complete blood count (CBC) results and Vitamin B12 levels of 81 Turkish and 53 Syrian immigrant children between January - June 2018 with a total of 134 children. Data about age, gender, nationality, CBC results, and B12 levels were retrospectively obtained from hospital records. The obtained data were statistically reviewed. Results: Mean B12 levels of Turkish children (336.6 mg/ml) was significantly higher than Syrian children (271 pg/ml) (p=0.004). 16% (n=13) of Turkish children had Vitamin B12 levels below 200 pg/ml and 31% (n=25) between 200-300 pg/ml whereas 30% (n=16) of Syrian children had Vitamin B12 levels below 200 pg/ml and 45% (n=24) between 200-300 pg/ml. Hematocrit (Hct) values in Turkish children (36.6±2.9) was significantly higher than Syrian children (34.6±4.8) (p=0.04). Conclusion: Immigrant children face issues complying with a balanced and healthy diet due to difficulties in accessing healthy foods. It is essential to take all necessary precautions including nutritional support for the healthy mental and physical development and growth of these children. Keywords: Vitamin B12; Children; Refugee