1. Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project
- Author
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Engle-Stone, Reina, Aaron, Grant J, Huang, Jin, Wirth, James P, Namaste, Sorrel Ml, Williams, Anne M, Peerson, Janet M, Rohner, Fabian, Varadhan, Ravi, Addo, O Yaw, Temple, Victor, Rayco-Solon, Pura, Macdonald, Barbara, and Suchdev, Parminder S
- Subjects
Biomedical and Clinical Sciences ,Nutrition and Dietetics ,Clinical Sciences ,Hematology ,Prevention ,Pediatric ,Nutrition ,Vector-Borne Diseases ,Rare Diseases ,Infectious Diseases ,Infection ,Good Health and Well Being ,Anemia ,Anemia ,Iron-Deficiency ,Anthropometry ,Biomarkers ,Child ,Preschool ,Cross-Sectional Studies ,Hemoglobins ,Humans ,Infant ,Infections ,Inflammation ,Iron Deficiencies ,Malaria ,Micronutrients ,Nutritional Status ,Socioeconomic Factors ,anemia ,children ,inflammation ,iron ,survey ,Engineering ,Medical and Health Sciences ,Nutrition & Dietetics ,Clinical sciences ,Nutrition and dietetics - Abstract
Background: A lack of information on the etiology of anemia has hampered the design and monitoring of anemia-control efforts.Objective: We aimed to evaluate predictors of anemia in preschool children (PSC) (age range: 6-59 mo) by country and infection-burden category.Design: Cross-sectional data from 16 surveys (n = 29,293) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed separately and pooled by category of infection burden. We assessed relations between anemia (hemoglobin concentration 50% of surveys. Associations between breastfeeding and anemia were attenuated by controlling for child age, which was negatively associated with anemia. The most consistent predictors of severe anemia were malaria, poor sanitation, and underweight. In multivariable pooled models, child age, iron deficiency, and stunting independently predicted anemia and severe anemia. Inflammation was generally associated with anemia in the high- and very high-infection groups but not in the low- and medium-infection groups. In PSC with anemia, 50%, 30%, 55%, and 58% of children had concomitant iron deficiency in low-, medium-, high-, and very high-infection categories, respectively.Conclusions: Although causal inference is limited by cross-sectional survey data, results suggest anemia-control programs should address both iron deficiency and infections. The relative importance of factors that are associated with anemia varies by setting, and thus, country-specific data are needed to guide programs.
- Published
- 2017