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Published on: January 19, 2024
Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among
Maria A Caravedo1, Maria Luisa Morales2, Melinda Tanabe1
1Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas.
Insights
Iron deficiency contributes to anemia in high-altitude children in Peru, alongside factors like younger age and maternal education. Further research on iron status is crucial for this vulnerable population.
Area of Science:
- Pediatric Hematology
- Environmental Health
- Nutritional Epidemiology
Background:
- Anemia is a global health issue influenced by diet, infections, and blood loss.
- High-altitude living presents unique physiological adaptations (higher hemoglobin) but also challenges like hypoxemia, infections, and dietary limitations.
- Understanding anemia's multifactorial nature in high-altitude pediatric populations is critical for targeted interventions.
Purpose of the Study:
- To identify factors associated with hemoglobin concentration and anemia in children residing in high-altitude rural communities in Peru.
- To investigate the role of iron status and helminth infections in pediatric anemia at high altitudes.
Main Methods:
- A cross-sectional study involving 2,000 children aged 3-16 years in Anta province, Peru.
- Data collection included demographic, socioeconomic, medical history, anthropometric measurements, and blood/stool samples.
- Analyses included complete blood counts, iron status markers (serum iron, transferrin saturation), and helminth infection testing.
Main Results:
- The prevalence of anemia (WHO definition) was 16% (320 children).
- Anemia was significantly associated with lower serum iron (OR 2.8) and transferrin saturation (OR 2.8).
- Independent risk factors for anemia included younger age (OR 0.85), stunting (OR 0.68), lower maternal education (OR 0.94), and low eosinophils (OR 0.49); helminth infections were not associated.
Conclusions:
- Anemia in high-altitude Peruvian children is multifactorial, with iron deficiency being a significant contributing factor.
- Factors beyond infection, such as nutritional status and socioeconomic determinants, play a role.
- Further research is warranted to comprehensively assess iron status and develop effective strategies to combat anemia in this population.
Abstract:
Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3-16 years of age attending public schools were invited to participate. We enrolled children 3-16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35-3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2-3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2-3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82-0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59-0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91-0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26-0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.
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