Determinants of Anemia among School-Aged Children in Mexico, the United States and Colombia Open Access

Abstract

Background: Anemia affects half of the world's global population of pre-school children and a quarter of the world's school-aged children (SAC). Anemia is most commonly ascribed to iron deficiency (ID); however, other nutritional, infectious, and socio-economic determinants are often not concurrently measured. Data is lacking on reliable international estimates of anemia and its determinants in SAC. Such statistics are important to guide anemia prevention and treatment programs. Our study aims to measure, in three countries with varying anemia burdens, anemia prevalence in SAC and its association with anthropometric, biochemical, demographic and socio-economic determinants.

Methods: Data was obtained from three national cross-sectional surveys - 2005-6 Mexican National Nutrition Survey, 2010 Encuesta Nacional de Nutrición Situación Colombia and 2003-6 cycles of the US National Health and Nutrition Examination Survey. The prevalence of anemia and ID was determined. Associations were studied using survey regression methods with adjustment for inflammation, potential confounders and complex survey design effects.

Results: Data was analyzed for 3650 Mexican, 3543 US children and 8604 Colombian aged 5-14.99 years. Mexican data showed 60% females, 10% stunted, 1% wasted, 13% overweight, 4% obese. Prevalence of anemia was 12%; ID was 18%. US data showed 48% females, 15% black, 1% stunted, 1.2% wasted, 19% overweight, 5% obese. Prevalence of anemia was 0.5%; ID of 9% was assessed in children aged 5 years and 12 to 14.99yr. Colombian data showed 58% females, 12% black, 10% stunted, 2% wasted, 4% overweight, 0.5% obese. Prevalence of anemia was 4%; ID was 9%. In Mexico, anemia was associated with being overweight (OR 0.4, p=0.007). In the US, anemia was associated with age category 12.0-14.99y (OR 4.6, p=0.03) and being female (OR 3.4, p=0.02). In Colombia, anemia was associated with being black (OR1.8, p<0.0001), being in the poorest quintile (OR 1.8, p<0.0001), overweight (OR 0.5, p<0.0001) and with stunting (OR 1.5, p<0.0001).

Conclusion: There was low anemia prevalence in Mexico with extremely low prevalence of anemia in Colombia and the US. ID was associated with anemia with inconsistent associations with socioeconomic factors in very low prevalence countries.

Table of Contents

TABLE OF CONTENTS

INTRODUCTION. 1

BACKGROUND. 3

METHODS. 6

RESULTS. 13

DISCUSSION. 16

FIGURES AND TABLES. 20

REFERENCES. 30

About this Master's Thesis

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School	Laney Graduate School
Department	Clinical Research Curriculum Program
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Keyword	School-Aged Children Anemia
Committee Chair / Thesis Advisor	Suchdev, Parminder S, Emory University
Committee Members	Barry, Vaughn, Emory University Klein, Mitchel, Emory University

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