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Anemia in Bolivian children: a comparative analysis among three regions of different altitudes
Dilberth Cordero1, Ana Maria Aguilar2, Carmen Casanovas3
1Independent Consultant, La Paz, Bolivia.
Insights
Childhood anemia prevalence in Bolivia remained stable, but increased significantly at high altitudes, posing a severe public health challenge. Diarrhea and maternal factors were key risk factors, necessitating policy review.
Area of Science:
- Global Health
- Pediatrics
- Nutritional Epidemiology
Background:
- Anemia affects over 40% of children aged 6-59 months in Bolivia, representing a severe public health issue.
- Trends in childhood anemia and associated risk factors across different altitudes remain under-investigated.
Purpose of the Study:
- To analyze trends in childhood anemia prevalence in Bolivia from 1998-2016.
- To identify sociodemographic risk factors associated with anemia across low, medium, and high altitude regions.
Main Methods:
- Analysis of four population-based demographic and health surveys (1998-2016).
- Examination of anemia prevalence in children aged 6-59 months by sociodemographic characteristics and altitude.
- Identification of consistent risk factors across altitude categories.
Main Results:
- Overall anemia prevalence remained unchanged, but increased in children at high altitudes.
- Diarrhea in the preceding two weeks was the most consistent risk factor across all altitude categories.
- Other risk factors included low length/height for age, adolescent or anemic mothers, low maternal education, and indigenous language.
Conclusions:
- Childhood anemia remains a critical public health problem in Bolivia, especially at high altitudes.
- Current anemia policies require review, prioritizing high-risk children.
- Further research is needed to understand non-iron deficiency causes of anemia and develop targeted interventions.
Abstract:
Here, we analyzed four population-based demographic and health surveys conducted in Bolivia between 1998 and 2016 to understand trends in anemia in children from 6 to 59 months of age by selected sociodemographic characteristics and three categories of altitude: low, medium, and high. Over the 18-year period, the prevalence of anemia was virtually unchanged while that in children living at high altitude increased. Anemia in children living at all three altitude categories is more than 40% and a severe public health problem according to the World Health Organization. We did not identify a single consistent risk factor for anemia in children living at high altitude compared with those living at medium or low altitude. The most consistent characteristic associated with childhood anemia across the three altitude categories was diarrhea in the last 2 weeks. Low length/height for age, an adolescent or anemic mother, a mother with no or little education, and a mother who speaks Quechua or Aymara were also risk factors. We conclude that it is necessary to review anemia policies and programs and prioritize children who are at greatest risk of developing anemia, particularly those living at high altitude. As iron deficiency appears to explain only a small part of childhood anemia, there is also a need to better understand its other causes and develop appropriate interventions.
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