Age, Ethnicity, Glucose-6-Phosphate Dehydrogenase Deficiency, Micronutrient Powder Intake, and Biomarkers of Micronutrient Status, Infection, and Inflammation Are Associated with Anemia Among Children 6–59 Months in Nepal

Details

• Alternative Title:
  J Nutr
• Personal Author:
  Ford, Nicole D ; Bichha, RP ; Parajuli, Kedar Raj ; Paudyal, Naveen ; Joshi, Nira ; Whitehead, Ralph D ; Chitekwe, Stanley ; Mei, Zuguo ; Flores-Ayala, Rafael ; Adhikari, Debendra P ; Rijal, Sanjay ; Jefferds, Maria Elena
• Description:
  Background
  
  Anemia is a major concern for children in Nepal; however, little is known about context-specific causes of anemia.
  
  Objective
  
  We used cross-sectional data from the 2016 Nepal National Micronutrient Status Survey to evaluate factors associated with anemia in a nationally representative, population-based sample of children 6–59 mo (n = 1367).
  
  Methods
  
  Hemoglobin, biomarkers of iron status and other micronutrients, infection, inflammation, and blood disorders were assessed from venous blood samples. Soil-transmitted helminth (STH) and Helicobacter pylori infections were assessed from stool. Anthropometry was measured with standard procedures. Sociodemographic and household characteristics, diet, micronutrient powder (MNP) intake, pica, and morbidity recall were ascertained by caregiver interview. Multivariable logistic regression that accounted for complex sampling design, determined predictors of anemia (hemoglobin <11.0 g/dL, altitude adjusted); candidate predictors were variables with P < 0.05 in bivariate models.
  
  Results
  
  Anemia prevalence was 18.6% (95% CI: 15.8, 21.4). MNP intake [adjusted OR (AOR): 0.25, 95% CI: 0.07, 0.86], log (ln) ferritin (μg/L) (AOR: 0.49, 95% CI: 0.38, 0.64), and ln RBP (μmol/L) (AOR: 0.42, 95% CI: 0.18, 0.95) were associated with reduced odds of anemia. Younger age (6–23 mo compared with 24–59 mo; AOR: 2.29, 95% CI: 1.52, 3.46), other Terai ethnicities (AOR: 2.59, 95% CI: 1.25, 5.35) and Muslim ethnicities (AOR: 3.15, 95% CI: 1.30, 7.65) relative to Brahmin/Chhetri ethnicities, recent fever (AOR: 1.68, 95% CI: 1.08, 2.59), ln C-reactive protein (mg/L) (AOR: 1.23, 95% CI: 1.03, 1.45), and glucose-6-phosphate dehydrogenase deficiency (AOR: 2.84, 95% CI: 1.88, 4.30) were associated with increased odds of anemia.
  
  Conclusion
  
  Both nonmodifiable and potentially modifiable factors were associated with anemia. Thus some but not all anemia might be addressed through effective public health policy, programs, and delivery of nutrition and infection prevention and control. J Nutr 2019;00:1–9.
  
  
• Subjects:
  Anemia Biomarkers Ethnicity Female Glycogen Storage Disease Type I Humans Infant Inflammation Male Micronutrients Nepal

  More +
• Keywords:
  Anemia Child Nutrition Infection Iron Deficiency Micronutrient Status Vitamin A Deficiency
• Source:
  J Nutr. 150(4):929-937
• Pubmed ID:
  31883009
• Pubmed Central ID:
  PMC7350881
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  150
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1ea6dfeda9a0a5574864e6fb1819022d43fafb8097fda28b297d28b302125cc9
• Download URL:
  https://stacks.cdc.gov/view/cdc/90426/cdc_90426_DS1.pdf
• File Type:
  [PDF - 532.98 KB ]