Anemia, Growth Impairment, and Micronutrients Status in Syrian Children Aged 12-60 Months

Background: Anemia and growth impairment are major health problems in children under 5 years in countries with ongoing crises. Aim: The aim of this study is to investigate the prevalence of anemia; low z scores for height for age, weight for age, and weight for height; and elevated plasma total homocysteine (tHcy) and low folate and vitamin B₁₂ concentrations in Syrian children aged 12-60 months. Methods: This cross-sectional study included 344 children of whom physical growth was measured. Blood count and circulating biomarkers of folate and B₁₂ and blood count were measured in a subgroup of the children. Data were collected on sociodemographic and contextual factors. Results: Anemia (age-specific cutoff values for hemoglobin according to the World Health Organization) was detected in 24.4% of the children. The height-for-age z score was < -2 in 32.0%, the weight-for-age z score was < -2 in 16.3%, and the weight-for height z sore< -2 in 1.5% of the children. The concentrations of tHcy, folate, and vitamin B₁₂ were (median and (10th, 90th percentiles)) 8.4 (5.6, 12.3) μmol/L, 24.0 (9.3, 34.7) nmol/L, and 198 (123, 367) pmol/L, respectively. Anemia and child anthropometric measures were not associated with elevated tHcy, low folate, or low B₁₂ concentrations. Conclusion: Anemia and low height- or weight-to-age z scores are highly prevalent among Syrian preschool children. Low folate or vitamin B₁₂ status was common, but they did not explain these conditions. Future studies may investigate whether early life multinutrient interventions may improve child growth and anemia.