Anemia and Iron Deficiency in Vietnamese Children, 6 to 11 Years Old

Population-based reference intervals for ferritin, iron, transferrin and transferrin saturation and prevalence of iron deficiency in 6-12-year-old children: the Health Oriented Pedagogical Project (HOPP)

Appropriate reference intervals are important for correct interpretation of laboratory test results. The primary objective of the present study was to establish pediatric reference intervals for biochemical markers essential in the assessment of iron status. As a secondary objective we calculated the prevalence of iron deficiency according to WHO recommendations. Blood samples were obtained from 1355 healthy children 6-12 years of age participating in the Health Oriented Pedagogical Project (HOPP). For our primary objective, data from 1333 children were used to establish reference intervals for ferritin, iron, transferrin and transferrin saturation. Following the CLSI C28-A3 guidelines, the 2.5^th and 97.5^th percentiles with corresponding 90% confidence intervals, were estimated by the nonparametric method. None of the measured analytes required partitioning for age or sex. The prevalence of iron deficiency was 8.2%, which is higher than reported in other populations.

Subclinical Iron Deficiency in Non-Anemic Individuals: A Retrospective Analysis of Korean Health Examinees

OBJECTIVES

Non-anemic individuals may have undetected subclinical iron deficiency (SID). The aims of this study were to determine the prevalence of SID and identify the associated factors for SID. In addition, the screening performance of red blood cell (RBC) indices for SID in health check-ups was assessed.

METHODS

This study was conducted with 16,485 non-anemic health examinees (3,567 males and 12,918 females) who underwent tests for iron variables (serum iron, total iron-binding capacity, ferritin, and iron saturation) at 16 health-promotion centers in 13 cities in Korea between January 2017 and June 2018. SID was defined as a decreased ferritin level (<24 µg/L in males and <15 µg/L in females) and either a decreased serum iron level (<44 µg/dL in males and <29 µg/dL in females) or a transferrin saturation of <20%.

RESULTS

The prevalence rates of SID were 0.6 and 3.3% in males and females, respectively. In terms of age and sex, SID was most prevalent in males aged ≥70 years (7.8%) and females aged 15-49 years (7.6%). There were significant differences in the hemoglobin (Hb) level, white blood cell count, platelet count, mean corpuscular volume, mean corpuscular Hb (MCH), and RBC distribution width (RDW) between the SID and non-SID groups (p < 0.001). The factors associated with SID in males were older age (odds ratio, OR, 1.069, 95% confidence interval, CI, 1.03-1.109, p = 0.004), lower Hb (OR 0.58, 95% CI 0.345-0.976, p = 0.04), lower MCH (OR 0.433, 95% CI 0.298-0.629, p < 0.001), and higher RDW (OR 1.374, 95% CI 1.001-1.887, p = 0.049), while in females they were lower body mass index (BMI; OR 0.929, 95% CI 0.895-0.963, p < 0.001) and younger age (OR 0.954, 95% CI 0.945-0.963, p < 0.001), as well as lower Hb, lower MCH, and higher RDW. The AUC for the MCH (0.877, 95% CI 0.793-0.960 in males; 0.872, 95% CI 0.853-0.890 in females) indicates that the MCH at cut-offs of 29.2 and 29.3 pg are the best discriminators of SID in males and females, respectively (p < 0.001).

CONCLUSIONS

Reproductive-age females with a lower BMI and elderly males are high-risk groups for SID. MCH is a reliable RBC index for the screening of SID. For the population with defined risk factors, including females with lower BMI and elderly males, screening for SID is needed to prevent the development of anemia.

Anaemia and Its Relation to Demographic, Socio-economic and Anthropometric Factors in Rural Primary School Children in Hai Phong City, Vietnam

Little is known about the prevalence of anaemia and associated factors in school children in Vietnam. In this cross-sectional study, we aimed to determine the prevalence of anaemia and its subtypes, and the associations of types of anaemia with demographic, socio-economic and anthropometric factors among 6-9-year-old primary school children in rural areas of Hai Phong City, Vietnam. Haemoglobin (Hb) and mean corpuscular volume (MCV) were measured, and demographic, socio-economic and anthropometric data were collected in 893 children from eight primary schools. The prevalence of anaemia (Hb < 115 g/L) was 12.9% (95% CI: 8.1%, 19.9%), microcytic anaemia (Hb < 115 g/L and MCV < 80 fL) was 7.9% (95% CI: 5.3%, 11.6%) and normocytic anaemia (Hb < 115 g/L and MCV 80-90 fL) was 5.3% (95% CI: 2.9%, 9.5%). No child presented with macrocytic anaemia (Hb < 115 g/L and MCV > 90 fL). Children who were underweight, wasted, or in anthropometric failure (either underweight, stunted or wasted) were more likely to be anaemic (all p ≤ 0.004), and specifically, to have normocytic anaemia (all p ≤ 0.006), than those who were not underweight, wasted or in anthropometric failure. Stunted children were more likely to be anaemic (p = 0.018) than those who were not stunted. Overweight/obese children were less likely to be anaemic (p = 0.026) or have normocytic anaemia (p = 0.038) compared with children who were not overweight/obese. No anthropometric status indicator was associated with the risk of microcytic anaemia. No demographic or socio-economic factor was associated with any type of anaemia. Anaemia remains a public health issue in rural areas in Hai Phong City, Vietnam, and future approaches for its prevention and control should target undernourished primary school children.

Higher Rate of Iron Deficiency in Obese Pregnant Sudanese Women

AIM:

To assess the association between obesity and iron deficiency (ID).

MATERIAL AND METHODS:

Pregnant women were recruited from Saad Abualila Hospital, Khartoum, Sudan, during January–April 2015. Medical history (age, parity, gestational age) was gathered using questionnaire. Weight and height were measured, and body mass index (BMI) was calculated. Women were sub-grouped based on BMI into underweight (< 18.5 kg/m^2), normal weight (18.5–24.9 kg/m^2), overweight (25–29.9 kg/m^2) and obese (≥ 30 kg/m^2). Serum ferritin and red blood indices were measured in all studied women.

RESULTS:

Two (0.5%), 126 (29.8%), 224 (53.0%) and 71 (16.8%) out of the 423 women were underweight, normal weight, overweight and obese, respectively. Anemia (Hb <11 g/dl), ID (ferritin <15µg/l) and iron deficiency anemia (IDA) were prevalent in 57.7%, 21.3% and 12.1%, respectively. Compared with the women with normal BMI, significantly fewer obese women were anemic [25 (35.2%) vs. 108 (85.7%), P < 0.001] and significantly higher number of obese women [25 (35.2) vs. 22 (17.5, P = 0.015] had iron deficiency. Linear regression analysis demonstrated a significant negative association between serum ferritin and BMI (– 0.010 µg/, P= 0.006).

CONCLUSION:

It is evident from the current findings that prevalence of anaemia and ID showed different trends about BMI of pregnant women

Anaemia, iron deficiency and susceptibility to infection in children in sub-Saharan Africa, guideline dilemmas

Globally, anaemia, iron deficiency and infections are responsible for a majority of the morbidity and mortality that occurs among children. As iron is essential for erythropoiesis and the human immune system, as well as a crucial element for many pathogens, these three conditions often interact. This article considers the question - have the studies conducted so far unravelled the potential complex interaction between these factors sufficiently enough to be able to develop universally applicable guidelines about iron treatment in children? It is possible, however, that the area is too complex and diverse, with many sub-populations, and that not universal, but tailor-made guidelines are needed based on some agreed principles.