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Journal of Tropical Pediatrics 1989 35(2):87-91; doi:10.1093/tropej/35.2.87
© 1989 by Oxford University Press
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Erythrocyte Protoporphyrin Screening for Lead Poisoning in Bedouin Children. A Study from Kuwait

A. A. Shaltout, FRCPE, FRCP, Faculty of Medicine*,, Robert Guthrie, PhD**, M. Moussa, MSc*, H. Kandil, MBBS***, M. F. Hassan***, L. Dosari, MSc{dagger}, M. C. J. Hunt, FRCP*** and N. P. Fernando, FRCPE, FRCP{dagger}

*Departments of Pediatrics and Community Health, Kuwait University Kuwait
**University of New York at Buffalo USA
***Department of Pediatrics at Al Jahra Kuwait
{dagger}Al Amiri Hospital Kuwait
{dagger}{dagger}Department of Primary Health Care

FRCPE, FRCP,Department of Pediatrics, Faculty of Medicine, Kuwait University, PO Box 24923 Safat, PC 13110, Kuwait

Screening for lead poisoning can be performed by measuring either blood lead (PbB) or a haematological indicator such as erythrocyte protoporphyrin (EP). We have screened 902 infants and children aged from 3 months to 5 years amongst those attending three primary health care centres in Al Jahra govemorate of Kuwait. Blood specimens were collected by finger prick on Guthrie filter paper and the dried blood samples were mailed to the Central Laboratory of the Children's Hospital, Buffalo, USA. One hundred and eighty-four (20 per cent) had an elevated EP (<<50µg/dl). Of those 11 had values above 159 µg/dl; 140 children were further tested for blood lead levels (PbB) haemoglobin, mean cell volumes, and percentage of transferrin saturation; 41 had blood lead levels<<25µg/dl which is the current definition of elevated blood lead levels. Two children (2 per cent) were in Class IV, 17 (15 per cent) and 16 (14 per cent) were in Class II and Class III, respectively. There was a significant correlation between EP and PbB (r =0.686; P=>>0.001). Of 72 children with elevated EP and normal PbB, 32 were anaemic (Hb >> ;11 g/dl) and 20 had iron deficiency.

The role of tribal practices using lead contaminated preparations and their contribution to elevated blood lead levels is discussed.


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