Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children
Determinants of Anemia and Hemoglobin Concentration in Haitian School-Aged Children
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DOI：
10.4269/ajtmh.15-0073
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发表时间：
2015-11-01
影响因子：
3.3
通讯作者：
Wolff, Patricia B.
中科院分区：
文献类型：
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作者：
Iannotti, Lora L.;Delnatus, Jacques R.;Wolff, Patricia B.
贫血会减少体内的氧气运输，对儿童的生长和发育造成潜在的不可逆后果。学龄儿童贫血的决定因素证据有限。2012年至2013年，我们在海地进行了一项随机对照试验，以测试强化学校零食的功效。在3个时间点对3 - 13岁儿童（N = 1，047）的血红蛋白（Hb）浓度、人体测量和生物电阻抗测量进行纵向随访。在基线和终点收集饮食摄入量、传染病发病率、社会经济和人口统计学因素。广义最小二乘纵向回归模型和随机效应Logit模型确定了干预效应以外的贫血危险因素。基线时，70.6%的儿童贫血，2.6%严重贫血。发育迟缓增加了发生贫血的几率（校正比值比[OR]：1.48，95%置信区间[CI]：1.05 - 2.08）和严重贫血的几率（校正比值比：2.47，95% CI：1.30 - 4.71）。父母报告的维生素A补充剂和驱虫与Hb浓度呈正相关，而发烧和家禽饲养分别与Hb浓度和严重贫血的几率增加呈负相关。进一步的研究应该探索学龄儿童贫血的全部病因，包括遗传原因。
Anemia diminishes oxygen transport in the body, resulting in potentially irreversible growth and developmental consequences for children. Limited evidence for determinants of anemia exists for school-aged children. We conducted a cluster randomized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack. Children (N = 1,047) aged 3-13 years were followed longitudinally at three time points for hemoglobin (Hb) concentrations, anthropometry, and bioelectrical impedance measures. Dietary intakes, infectious disease morbidities, and socioeconomic and demographic factors were collected at baseline and endline. Longitudinal regression modeling with generalized least squares and logit models with random effects identified anemia risk factors beyond the intervention effect. At baseline, 70.6% of children were anemic and 2.6% were severely anemic. Stunting increased the odds of developing anemia (adjusted odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.05-2.08) and severe anemia (adjusted OR: 2.47, 95% CI: 1.30-4.71). Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations, whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia, respectively. Further research should explore the full spectrum of anemia etiologies in school children, including genetic causes.