Epidemiology of anemia among 4- to 17-month-old children living in south central Nepal

Abstract

Objective: To describe the distribution of hemoglobin and prevalence of anemia in Nepali children living in the Terai region by potential risk factors for deficiency. Design: This was a cross-sectional, community-based study of baseline characteristics of children enrolled in a randomized, placebo-controlled clinical trial between January and March 2002. Participants were weighed and measured and had their blood drawn. Their mothers contributed demographic, morbidity, and feeding data. Subjects: There were 569 4-to 17-month-old children. Statistical models were based on 490 children. Results: Anemia was prevalent: 58% of the children had a hemoglobin o105 g/l. Iron-deficiency anemia (anemia with erythrocyte protoporphyrin (EP) X90 mmol/mol heme) was present in 43% of the children. Severe anemia was rare: less than 2% of the children had a hemoglobin o70 g/l. The mean (s.d.) hemoglobin concentration was 101 (12.5) g/l. Stunting and wasting were prevalent: 30.8% were stunted (length-for-age Z-score oÀ2) and 18.1% were wasted (weight-for-length Z-score oÀ2). Bivariate analyses revealed that age, caste, socioeconomic status, dietary diversity, stunting, and underweight were associated with hemoglobin concentration and/or anemia. In multivariate models with and without EP, age and caste were found to be strong predictors of both hemoglobin concentration and anemia. Conclusions: Anemia and iron deficiency increased strongly with age and low-caste status among the study children. The data reveal the importance of targeting interventions to children in the first year of life before they become anemic and iron deficient.

Factors associated with anaemia status and haemoglobin concentrations in infants 6-11 months in Mbala district, northern province, Zambia

“…A relationship between age, haemoglobin concentration, and anaemia status is in line with the 2012 Zambian Malaria Indicator Survey, which found a decreasing prevalence of anaemia as age increased [3]. This has also been seen in Zanzibar and Nepal [25,26]. There were higher concentrations of haemoglobin in girls, who had an odds ratio for anaemia of 0.69 when compared to boys.…”

Beneficial effects of zinc supplementation on head circumference of Nepalese infants and toddlers: a randomized controlled trial

“…42,43 The strength of this study are its randomized design and the fact that it was carried out in a general population of healthy children where zinc and iron deficiencies are common. 17,18 A limitation of our study may have been the difference in head circumference between our treatment groups at baseline, leading us to control for baseline head circumference in all adjusted models. Unfortunately, we are unable to evaluate possible effect modification by baseline iron-folic acid and zinc status to assess if the impact would have been differential depending on deficiency at baseline.…”

“…1 Brain damage caused by malnutrition at an early age may be difficult to reverse, especially in impoverished settings where adequate stimulation in the home may be difficult to achieve. 16 Given the evidence for nutrition as an important predictor of head circumference and its significance for later cognitive performance [3][4][5][6][7] and the documented nutritional deficiencies in rural Nepal, 17,18 in the present study we use a randomized controlled trial to assess the effects of micronutrient supplementation on head circumference in rural Nepali infants and children.…”

Prevalence and Severity of Anaemia Among Hospitalised Children Aged 6-59 Months

“…17 Siegal EH et al have noted that stunting (30.8%) and wasting (18.1%) were prevalent in anaemic children studied between 4-17 months. 18 Anaemia increases the risk of infection and many times is indirectly a reason for hospitalisation. Though we found a high prevalence of anaemia in children suffering from respiratory tract diseases and central nervous system diseases, statistical significant association could not be made.…”