Underlying Factors Associated with Anemia in Amazonian Children: A Population-Based, Cross-Sectional Study
Underlying Factors Associated with Anemia in Amazonian Children: A Population-Based, Cross-Sectional Study
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DOI：
10.1371/journal.pone.0036341
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发表时间：
2012-05-04
期刊：
影响因子：
3.7
通讯作者：
Ferreira, Marcelo U.
中科院分区：
文献类型：
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作者：
Cardoso, Marly A.;Scopel, Kezia K. G.;Ferreira, Marcelo U.
背景资料：虽然缺铁被认为是全球儿童贫血的主要原因，但在发展中国家，对儿童贫血的其他因素的研究仍然很少。我们在一项基于人群的横断面调查中估计了不同因素对贫血的相对贡献。方法：我们从巴西西北部边境城镇Acrelandia的1111名6个月至10岁的儿童中采集静脉血样本，通过测量血红蛋白，红细胞指数，铁蛋白，可溶性转铁蛋白受体，和C反应蛋白浓度同时对儿童进行维生素A、维生素B-12和叶酸缺乏症、肠道寄生虫感染、葡萄糖-6-磷酸脱氢酶缺乏症和镰状细胞性状携带筛查。多元Poisson回归和校正的患病率（aPR）被用来描述贫血和自变量之间的关联。主要结果：贫血，缺铁，缺铁性贫血的患病率分别为13.6%，45.4%和10.3%，分别。与最低收入家庭相比，收入最高四分位数家庭的儿童患贫血的风险较低（aPR，0.60; 95%CI，0.37-0.98）。儿童年龄（2次妊娠，2.01; 1.40-2.87）与贫血呈正相关。其他相关因素包括缺铁（2.1; 1.4-3.0）、维生素B-12（1.4; 1.0-2.2）和叶酸（2.0; 1.3-3.1）缺乏和C-反应蛋白浓度（>5 mg/L，1.5; 1.1-2.2）。解决儿童和母亲的发病率和多种营养缺乏症以及提高较贫穷家庭的购买力，是减轻负担的潜在重要干预措施贫血症。
Background: Although iron deficiency is considered to be the main cause of anemia in children worldwide, other contributors to childhood anemia remain little studied in developing countries. We estimated the relative contributions of different factors to anemia in a population-based, cross-sectional survey.Methodology: We obtained venous blood samples from 1111 children aged 6 months to 10 years living in the frontier town of Acrelandia, northwest Brazil, to estimate the prevalence of anemia and iron deficiency by measuring hemoglobin, erythrocyte indices, ferritin, soluble transferrin receptor, and C-reactive protein concentrations. Children were simultaneously screened for vitamin A, vitamin B-12, and folate deficiencies; intestinal parasite infections; glucose-6-phosphate dehydrogenase deficiency; and sickle cell trait carriage. Multiple Poisson regression and adjusted prevalence ratios (aPR) were used to describe associations between anemia and the independent variables.Principal Findings: The prevalence of anemia, iron deficiency, and iron-deficiency anemia were 13.6%, 45.4%, and 10.3%, respectively. Children whose families were in the highest income quartile, compared with the lowest, had a lower risk of anemia (aPR, 0.60; 95% CI, 0.37-0.98). Child age (2 pregnancies, 2.01; 1.40-2.87) were positively associated with anemia. Other associated correlates were iron deficiency (2.1; 1.4-3.0), vitamin B-12 (1.4; 1.0-2.2), and folate (2.0; 1.3-3.1) deficiencies, and C-reactive protein concentrations (>5 mg/L, 1.5; 1.1-2.2).Conclusions: Addressing morbidities and multiple nutritional deficiencies in children and mothers and improving the purchasing power of poorer families are potentially important interventions to reduce the burden of anemia.