Underlying Factors Associated with Anemia in Amazonian Children: A Population-Based, Cross-Sectional Study

Author(s)

Cardoso, Marly A. ^[1] ; Scopel, Kezia K. G. ^[2] ; Muniz, Pascoal T. ^[3] ; Villamor, Eduardo ^[4] ; Ferreira, Marcelo U. ^[5]

Affiliation

^[1] Univ Sao Paulo. Sch Publ Hlth

^[2] Univ Fed Juiz de Fora. Dept Parasitol Immunol & Microbiol

^[3] Univ Fed Acre. Dept Hlth Sci

^[4] Univ Michigan. Sch Publ Hlth

^[5] Univ Sao Paulo. Inst Biomed Sci

• Document type: Journal article
• Source: PLoS One; v. 7, n. 5 MAY 4 2012.
• Web of Science Citations: 16

Abstract

Background: Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey. Methodology: We obtained venous blood samples from 1111 children aged 6 months to 10 years living in the frontier town of Acrelandia, northwest Brazil, to estimate the prevalence of anemia and iron deficiency by measuring hemoglobin, erythrocyte indices, ferritin, soluble transferrin receptor, and C-reactive protein concentrations. Children were simultaneously screened for vitamin A, vitamin B-12, and folate deficiencies; intestinal parasite infections; glucose-6-phosphate dehydrogenase deficiency; and sickle cell trait carriage. Multiple Poisson regression and adjusted prevalence ratios (aPR) were used to describe associations between anemia and the independent variables. Principal Findings: The prevalence of anemia, iron deficiency, and iron-deficiency anemia were 13.6%, 45.4%, and 10.3%, respectively. Children whose families were in the highest income quartile, compared with the lowest, had a lower risk of anemia (aPR, 0.60; 95% CI, 0.37-0.98). Child age (<24 months, 2.90; 2.01-4.20) and maternal parity (>2 pregnancies, 2.01; 1.40-2.87) were positively associated with anemia. Other associated correlates were iron deficiency (2.1; 1.4-3.0), vitamin B-12 (1.4; 1.0-2.2), and folate (2.0; 1.3-3.1) deficiencies, and C-reactive protein concentrations (>5 mg/L, 1.5; 1.1-2.2). Conclusions: Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia. (AU)