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Updated: Nov 22, 2025
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
[Influence of altitude on hemoglobin levels and determination of the adjusting values]
Junsheng Huo1, Weiyi Gong1, Jing Sun1
1Instutue for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Insights
This study establishes a relationship between infant hemoglobin levels and altitude, providing adjusted values for high-altitude areas. The findings offer new insights into infant nutrition in diverse geographical regions.
Area of Science:
- Pediatric Nutrition
- Environmental Health
- Biostatistics
Background:
- Infant hemoglobin levels are crucial for development.
- High altitude poses unique physiological challenges.
- Accurate hemoglobin assessment requires altitude-adjusted values.
Purpose of the Study:
- To determine the correlation between hemoglobin levels and altitude in 6-23 month old infants.
- To establish adjusted hemoglobin values for infants residing at high altitudes.
- To compare newly derived adjustment methods with existing ones.
Main Methods:
- Utilized data from the "Improvement of Nutrition in Children in Poor Rural Regions" study.
- Employed multi-stage stratified cluster sampling, PPS, and random equidistant methods for infant selection.
- Collected data via questionnaires and physical examinations; hemoglobin tested using HemoCue; altitude recorded by residence.
Main Results:
- Analyzed data from 24,938 infants (6-23 months) across 19 provinces.
- Found average hemoglobin of 11.9 g/dL, with altitude ranging from 10m to 4236m.
- Developed adjusted hemoglobin values (e.g., 1.2 g/dL at 4000m) lower than WHO recommendations, improving anemia rate assessment.
Conclusions:
- Existing hemoglobin adjustment values are not optimal for infants.
- New altitude-adjusted hemoglobin values are proposed for infants aged 6-23 months.
- This research refines anemia diagnosis in high-altitude populations.
Objective:
To establish the relationship between hemoglobin level of 6-23 month infants and altitude of their living places, and to determine the adjusting hemoglobin values for infants in high altitude areas.
Methods:
Conduct this study by using available data from Improvement of Nutrition in Children in Poor Rural Regions. 6-23 months infants were sampled with the method of combined multi-stage stratified cluster, PPS and random equidistant. Questionnaires were used to collect data of infants and their families, feeding practices and nutrition knowledge of caretakers. The weight and length were measured by the intelligent physical examination instrument. Hemoglobin was tested by HemoCue method with blood drop from finger tips. Altitude was checked by the residence regions. Linear regressions were used to analyze the relation quotation of hemoglobin and altitude, adjusting hemoglobin values were determined with the quotation. A comparison was observed among adjusting method of CDC, Dirren and the established.
Results:
A total of 24 938 infants at age of 6-23 months were sampled from 140 counties, in 19 provinces in 2018. Data were from 22 207 male accounting for 51. 7% and 20 731 female, 48. 3%. The weight, height and hemoglobin were(77. 6±6. 2)cm, (9. 91±1. 62)kg and 11. 9 g/dL respectively. The altitude ranges from 10 m to 4236 m, averagely 893. 4 m. Anemia rates of the infants and adjusted with method from CDC, Dirren and this study were 18. 9%, 27. 5%, 22. 7% and 20. 3%, showing remarkable adjusting effect. This study obtained adjusting Hb value for 1000, 2000, 3000 and 4000 m were 0. 1, 0. 3, 0. 6 and 1. 2 g/dL respectively and noticeably lower than that of suggested by WHO.
Conclusion:
Adjusting hemoglobin values of 6-23 months were different from the used values.
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