Details:

Alternative Title:
Matern Child Health J
Personal Author:
Wong, E. ; Molina-Cruz, R. ; Rose, C. ; Bailey, L. ; Kauwell, G. P. A. ; ... More +
Wong, E. ; Molina-Cruz, R. ; Rose, C. ; Bailey, L. ; Kauwell, G. P. A. ; Rosenthal, J. Less -
Description:
Background and Objective

Folate and vitamin B12 deficiencies can impair proper growth and brain development in children. Data on the folate and vitamin B12 status of children aged 6–59 months in Guatemala are scarce. Identification of factors associated with higher prevalence of these micronutrient deficiencies within the population is needed for national and regional policymakers.

Objective

To describe national and regional post-fortification folate and vitamin B12 status of children aged 6–59 months in Guatemala.

Methods

A multistage, cluster probability study was carried out with national and regional representation of children aged 6–59 months. Demographic and health information was collected for 1246 preschool children, but blood samples for red blood cell (RBC) folate and vitamin B12 were collected and analyzed for 1,245 and 1143 preschool children, respectively. We used the following deficiency criteria as cutoff points for the analyses: < 305 nmol/L for RBC folate, < 148 pmol/L for vitamin B12 deficiency, and 148–221 pmol/L for marginal vitamin B12 deficiency. Prevalence of RBC folate deficiency and vitamin B12 deficiency and marginal deficiency were estimated. Prevalence risk ratios of RBC folate and vitamin B12 deficiency were estimated comparing subpopulations of interest.

Results

The national prevalence estimates of RBC folate deficiency among children was 33.5% [95% CI 29.1, 38.3]. The prevalence of RBC folate deficiency showed wide variation by age (20.3–46.6%) and was significantly higher among children 6–11 months and 12–23 months (46.6 and 37.0%, respectively), compared to older children aged 48–59 months (20.3%). RBC folate deficiency also varied widely by household wealth index (22.6–42.0%) and geographic region (27.2–46.7%) though the differences were not statistically significant. The national geometric mean for RBC folate concentrations was 354.2 nmol/L. The national prevalences of vitamin B12 deficiency and marginal deficiency among children were 22.5% [95% CI 18.2, 27.5] and 27.5% [95% CI 23.7, 31.7], respectively. The prevalence of vitamin B12 deficiency was significantly higher among indigenous children than among non-indigenous children (34.5% vs. 13.1%, aPRR 2.1 95% CI 1.4, 3.0). The prevalence of vitamin B12 deficiency also significantly varied between the highest and lowest household wealth index (34.3 and 6.0%, respectively). The national geometric mean for vitamin B12 concentrations was 235.1 pmol/L. The geometric means of folate and B12 concentrations were significantly lower among children who were younger, had a lower household wealth index, and were indigenous (for vitamin B12 only). Folate and vitamin B12 concentrations showed wide variation by region (not statistically significant), and the Petén and Norte regions showed the lowest RBC folate and vitamin B12 concentrations, respectively.

Conclusions

In this study, a third of all children had RBC folate deficiency and half were vitamin B12 deficient. Folate deficiency was more common in younger children and vitamin B12 deficiency was more common in indigenous children and those from the poorest families. These findings suggest gaps in the coverage of fortification and the need for additional implementation strategies to address these gaps in coverage to help safeguard the health of Guatemalan children.


Subjects:
[+]
Adolescent Article Child Child, Preschool Folic Acid Folic Acid Deficiency Guatemala Humans Infant Micronutrient Deficiencies Preschool Children Prevalence Red Blood Cell Folate Deficiency Vitamin B 12 Vitamin B12 Deficiency Vitamin B 12 Deficiency
Source:
Matern Child Health J. 26(1):156-167
Pubmed ID:
34637065
Pubmed Central ID:
PMC8770614
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:3bf45e0544edf4b1bbba7e8dcaf88c791da5b8af187c4b79dc5bcebf603ac6cd
Download URL:
https://stacks.cdc.gov/view/cdc/113682/cdc_113682_DS1.pdf
File Type:

Supporting Files

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