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Updated: May 23, 2026
A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
Prevalence of anemia among Quebec Cree infants from 2002 to 2007 compared with 1995 to 2000
Noreen Willows1, David Dannenbaum, Sophie Vadeboncoeur
1Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Canada. noreen.willows@ualberta.ca
Insights
Anemia screening in Cree infants in Quebec showed a significant decrease in prevalence from 31.7% to 12.5% between 1995-2000 and 2002-2007. This suggests a potential shift from universal to targeted screening for anemia in infants.
Area of Science:
- Pediatric Health
- Public Health Interventions
- Nutritional Anemia
Background:
- Anemia screening at 9 months is crucial for infant health.
- Previous data indicated a high prevalence of anemia in Quebec Cree infants.
- Evaluating screening effectiveness is essential for resource allocation.
Purpose of the Study:
- To assess the change in anemia prevalence among Cree infants in Quebec.
- To compare anemia rates between 1995-2000 and 2002-2007 screening periods.
- To inform decisions regarding the continuation of universal infant anemia screening.
Main Methods:
- Cross-sectional study comparing two distinct screening periods (1995-2000 and 2002-2007).
- Analysis of anemia prevalence based on hemoglobin concentration in 716 infants (1995-2000) and 1325 infants (2002-2007).
- Used non-overlapping 95% confidence intervals (CIs) to determine statistical significance.
Main Results:
- Anemia prevalence (hemoglobin < 110 g/L) decreased significantly from 31.7% to 12.5%.
- Iron deficiency anemia prevalence (hemoglobin < 100 g/L) dropped from 7.5% to 2.0%.
- Mean hemoglobin levels increased from 114 g/L to 121 g/L.
Conclusions:
- The reduced anemia prevalence suggests screening interventions have been effective.
- While lower, the 12.5% anemia rate is higher than non-Aboriginal infants (8.0%).
- Consideration of targeted screening for high-risk infants is recommended, pending further risk factor studies.
Objective:
To determine if screening of infants for anemia at 9 months in the Cree region of Quebec should continue,by comparing the prevalence of anemia in the initial years of screening (1995 to 2000) with prevalence data from infants screened between 2002 and 2007.
Design:
Comparison of anemia prevalence from 2 cross-sectional surveys. Nonoverlapping 95% CIs were used to determine if results were significantly different.
Setting:
Nine Quebec Cree communities. Participants Infants screened for anemia between 1995 and 2000 (n = 716) or 2002 and 2007 (n = 1325). Main outcome measures Anemia was diagnosed based on hemoglobin concentration. An erythrocyte mean cell volume of less than 71 fL was used as a proxy for iron deficiency.
Results:
Hemoglobin concentration among infants screened from 2002 to 2007 was, on average, 7 g/L greater than among infants screened from 1995 to 2000 (mean [standard deviation] 121 [11] g/L vs 114 [11] g/L). The prevalence of anemia (hemoglobin < 110 g/L) from 1995 to 2000 was 31.7% (95% CI 28.3% to 35.1%), but from 2002 to 2007 it was significantly lower at 12.5% (95% CI 10.7% to 14.2%). Using a hemoglobin concentration more specific to iron deficiency anemia (IDA) (hemoglobin < 100 g/L), from 1995 to 2000 7.5% (95% CI 5.6% to 9.4%) of infants had IDA, whereas from 2002 to 2007 only 2.0% (95% CI 1.2% to 2.8%) had IDA. The prevalence of iron deficiency based on mean cell volume declined from 18.3% (95% CI 15.5% to 21.1%) from 1995 to 2000 to 4.2% (95% CI 3.1% to 5.3%) from 2002 to 2007.
Conclusion:
The 12.5% prevalence of anemia (hemoglobin < 110 g/L) among Cree infants from 2002 to 2007 was much lower than the prevalence from 1995 to 2000 but somewhat higher than among nonaboriginal infants (8.0%). The low anemia prevalence among Quebec Cree infants after 2002 suggests that replacing universal screening with targeted screening of higher-risk infants needs to be considered following studies to identify risk factors for anemia.
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