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Determinants of anemia among young children in rural India.
Pediatrics 2010; 126(1):e140-9Ped

Abstract

OBJECTIVE

More than 75% of Indian toddlers are anemic. Data on factors associated with anemia in India are limited. The objective of this study was to determine biological, nutritional, and socioeconomic risk factors for anemia in this vulnerable age group.

METHODS

We conducted a cross-sectional study of children aged 12 to 23 months in 2 rural districts of Karnataka, India. Children were excluded if they were unwell or had received a blood transfusion. Hemoglobin, ferritin, folate, vitamin B(12), retinol-binding protein, and C-reactive protein (CRP) levels were determined. Children were also tested for hemoglobinopathy, malaria infection, and hookworm infestation. Anthropometric measurements, nutritional intake, family wealth, and food security were recorded. In addition, maternal hemoglobin level was measured.

RESULTS

Anemia (hemoglobin level < 11.0 g/dL) was detected in 75.3% of the 401 children sampled. Anemia was associated with iron deficiency (low ferritin level), maternal anemia, and food insecurity. Children's ferritin levels were directly associated with their iron intake and CRP levels and with maternal hemoglobin level and inversely associated with continued breastfeeding and the child's energy intake. A multivariate model for the child's hemoglobin level revealed associations with log(ferritin level) (coefficient: 1.20; P < .001), folate level (0.05; P < .01), maternal hemoglobin level (0.16; P < .001), family wealth index (0.02; P < .05), child's age (0.05 per month; P < .005), hemoglobinopathy (-1.51; P < .001), CRP level (-0.18; P < .001), and male gender (-0.38; P < .05). Wealth index and food insecurity could be interchanged in this model.

CONCLUSIONS

Hemoglobin level was primarily associated with iron status in these Indian toddlers; however, maternal hemoglobin level, family wealth, and food insecurity were also important factors. Strategies for minimizing childhood anemia must include optimized iron intake but should simultaneously address maternal anemia, poverty, and food insecurity.

Authors+Show Affiliations

Nossal Institute for Global Health, University of Melbourne, Parkville, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20547647

Citation

Pasricha, Sant-Rayn, et al. "Determinants of Anemia Among Young Children in Rural India." Pediatrics, vol. 126, no. 1, 2010, pp. e140-9.
Pasricha SR, Black J, Muthayya S, et al. Determinants of anemia among young children in rural India. Pediatrics. 2010;126(1):e140-9.
Pasricha, S. R., Black, J., Muthayya, S., Shet, A., Bhat, V., Nagaraj, S., ... Shet, A. S. (2010). Determinants of anemia among young children in rural India. Pediatrics, 126(1), pp. e140-9. doi:10.1542/peds.2009-3108.
Pasricha SR, et al. Determinants of Anemia Among Young Children in Rural India. Pediatrics. 2010;126(1):e140-9. PubMed PMID: 20547647.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants of anemia among young children in rural India. AU - Pasricha,Sant-Rayn, AU - Black,James, AU - Muthayya,Sumithra, AU - Shet,Anita, AU - Bhat,Vijay, AU - Nagaraj,Savitha, AU - Prashanth,N S, AU - Sudarshan,H, AU - Biggs,Beverley-Ann, AU - Shet,Arun S, Y1 - 2010/06/14/ PY - 2010/6/16/entrez PY - 2010/6/16/pubmed PY - 2010/7/29/medline SP - e140 EP - 9 JF - Pediatrics JO - Pediatrics VL - 126 IS - 1 N2 - OBJECTIVE: More than 75% of Indian toddlers are anemic. Data on factors associated with anemia in India are limited. The objective of this study was to determine biological, nutritional, and socioeconomic risk factors for anemia in this vulnerable age group. METHODS: We conducted a cross-sectional study of children aged 12 to 23 months in 2 rural districts of Karnataka, India. Children were excluded if they were unwell or had received a blood transfusion. Hemoglobin, ferritin, folate, vitamin B(12), retinol-binding protein, and C-reactive protein (CRP) levels were determined. Children were also tested for hemoglobinopathy, malaria infection, and hookworm infestation. Anthropometric measurements, nutritional intake, family wealth, and food security were recorded. In addition, maternal hemoglobin level was measured. RESULTS: Anemia (hemoglobin level < 11.0 g/dL) was detected in 75.3% of the 401 children sampled. Anemia was associated with iron deficiency (low ferritin level), maternal anemia, and food insecurity. Children's ferritin levels were directly associated with their iron intake and CRP levels and with maternal hemoglobin level and inversely associated with continued breastfeeding and the child's energy intake. A multivariate model for the child's hemoglobin level revealed associations with log(ferritin level) (coefficient: 1.20; P < .001), folate level (0.05; P < .01), maternal hemoglobin level (0.16; P < .001), family wealth index (0.02; P < .05), child's age (0.05 per month; P < .005), hemoglobinopathy (-1.51; P < .001), CRP level (-0.18; P < .001), and male gender (-0.38; P < .05). Wealth index and food insecurity could be interchanged in this model. CONCLUSIONS: Hemoglobin level was primarily associated with iron status in these Indian toddlers; however, maternal hemoglobin level, family wealth, and food insecurity were also important factors. Strategies for minimizing childhood anemia must include optimized iron intake but should simultaneously address maternal anemia, poverty, and food insecurity. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/20547647/Determinants_of_anemia_among_young_children_in_rural_India_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=20547647 DB - PRIME DP - Unbound Medicine ER -