Efectos del consumo de alimentos en la concentración de hemoglobina y el riesgo de anemia infantil en el Perú - 2018 / Effects of Food Consumption on Hemoglobin Concentration and the risk of Childhood Anemia in Peru - 2018

RESUMEN Objetivo: Caracterizar y medir el efecto del consumo de alimentos sobre la concentración de hemoglobina y el riesgo de amenia en niños menores de tres años en el Perú. Materiales y métodos: Se empleó datos de corte transversal de la Encuesta Nacional de Hogares (ENAHO) y la Encuesta Demográfica y de Salud Familiar (ENDES) de 2018. En la estimación del efecto del consumo de alimentos sobre la concentración de hemoglobina se empleó el modelo de regresión lineal múltiple; mientras que para medir el efecto de consumo de alimentos sobre el riego de anemia se empleó el modelo de regresión probit. Resultados: Se encontró que el consumo de lechuga, apio y beterrega (verduras), hígado (carne roja), papaya (fruta) contribuyen positivamente sobre la concentración de hemoglobina y la reducción del riesgo de anemia. La papa (tubérculo) contribuye positivamente en el incremento de la hemoglobina y la reducción del riesgo de anemia para niveles de consumo por debajo de 50 kilogramos por año. Entre las variables de control resultaron altanamente significativos las características biológicas de la madre y el niño, las características socioeconómicas del hogar y las características de la vivienda y del hogar. Conclusión: El mayor consumo de hígado de res, lechuga y beterraga produce mayores niveles de hemoglobina, mientras el consumo de papa por debajo de 50 kg en promedio anual contribuye a la reducción del riesgo de anemia, y mayor consumo de apio y papaya genera una menor probabilidad de riesgo de contraer anemia.

ABSTRACT Objective: To characterize and measure the effect of food consumption on the concentration of hemoglobin and the risk of anemia in children under three years of age, in Peru. Materials and Methods: Cross-sectional data from the National Household Survey ENAHO and the Demographic and Family Health Survey ENDES of 2018 were used. In estimating the efect of food consumption on hemoglobin concentration, the linear multiple regression model was used; while the probit regression model was used to measure the effect of food consumption on the risk of anemia. Results. The consumption of lettuce, celery, and beet (vegetables), liver (red meat), papaya (fruit) was found to positively contribute to the concentration of hemoglobin and the reduction of the risk of anemia. Potatoes (tuber) contribute positively to increasing hemoglobin and reducing the risk of anemia, for consumption levels below 50 kilograms per year. Among the control variables, the biological characteristics of the mother and child, the socioeconomic characteristics of the household, and the characteristics of the region and community were highly significant. Conclusion: Higher consumption of beef liver, lettuce, and beets produces higher levels of hemoglobin, while the consumption of potatoes, below 50 kg on a yearly average, contributes to the reduction of the risk of anemia, and higher consumption of celery and papaya generates a lower probability risk of anemia.

Investigation and analysis of the effects of single and combined supplement intervention on anemia related indexes in rural children in Qinghai Province / 公共卫生与预防医学

Objective To analyze the effects of different supplements on anemia related indexes in rural children. Methods A stratified method was adopted, and six villages (towns) in and around Qinghai Province were selected as intervention sits for the present study. A total of 304 children from 2 to 6 years old at each intervention site meeting the inclusion criteria were screened and divided into three groups (A, B, and C), who were intervened for 3 months. Serum vitamin A, vitamin D and hemoglobin levels were measured before and after the intervention. Results The hemoglobin level of 304 children before intervention was (118.65±16.07) g /L, and the prevalence of anemia was 9.54%. The vitamin A value, vitamin D value and hemoglobin value were increased after three months of the intervention. The changes of vitamin A value, vitamin D value and hemoglobin value in rural children in group C were significantly higher than those in groups A and B. The increase in vitamin A value in rural children aged 3 years was significantly higher than that in other age groups, and the increase in hemoglobin in rural children of 1 year old was significantly higher than that in other age groups. The increase in vitamin A value of rural children of other ethnic groups (mainly Tibetans) was significantly higher than that of Han and Hui nationalities, and the increase of hemoglobin value in Hui rural children was significantly higher than that in Han and other ethnic groups. Conclusion Vitamin A combined with iron dextran tablets was effective in preventing anemia in rural children.

Anemia infantil en poblaciones que residen a diferentes altitudes geográficas de Arequipa, Perú: estudio descriptivo y retrospectivo / Childhood anemia in populations residing at different geographical altitudes of Arequipa, Peru: a descriptive and retrospective study

OBJETIVO: Identificar si existe una relación estadística entre el diagnóstico de anemia en niños y vivir a distintas altitudes geográficas de la Región Arequipa, Perú. MÉTODOS: Se realizó un estudio descriptivo y retrospectivo. La población estuvo constituida por 106 499 niños y niñas menores de cinco años que viven en la Región Arequipa a distintas altitudes geográficas, de los cuales presentaron anemia 32 454 que corresponde al 30,5%, atendidos por el Ministerio de Salud de Arequipa. Se tomaron datos sociodemográficos relacionados con edad, provincia, beneficiario del programa de Sistema Integral de Salud (SIS), de visitas domiciliarias, de Control de Crecimiento y Desarrollo (CRED); además de datos vinculados a la anemia como frecuencia, hemoglobina y severidad. RESULTADOS: Los resultados fueron categorizados según la altitud geográfica de procedencia de los niños y niñas de 0 a 59 meses de edad y los niveles de hemoglobina según la altitud geográfica. De la muestra estudiada, la frecuencia de anemia a diferentes altitudes geográficas de Arequipa en niños menores de cinco años para el período de 2017 a 2019 fue de 18,7% entre 0 y 999 metros sobre el nivel del mar; 29,6% entre 1000 y 1999 metros; 31,6% entre 2000 y 2999 metros; 42,9% entre 3000 y 3999 metros, y 54,4% entre 4000 y 4999 metros sobre el nivel del mar. Hubo mayor prevalencia de anemia cuando se utilizó el factor de corrección por altitud geográfica. CONCLUSIONES: Se observó una relación estadística significativa (p < 0,05) entre la hemoglobina corregida según parámetros de la Organización Mundial de la Salud y la altitud en la que viven los niños con anemia, es decir, a mayor altitud geográfica mayor anemia en niños. Los programas de suplementación deben tener correspondencia con las visitas domiciliarias y la evaluación del crecimiento y desarrollo de los niños.

OBJECTIVE: To identify the characteristics of anemia in children living at different geographical altitude in the Arequipa Region of Peru. METHODS: We did a descriptive and retrospective study. The population consisted of 106 499 children under five years of age living in the Arequipa Region at different geographical altitude and receiving care by the Ministry of Health of Arequipa. Of these, 32 454 had anemia (30.5%). Socio-demographic data related to age, province, and beneficiary of the Comprehensive Health System program, home visits, and growth and development were obtained, in addition to data regarding anemia such as frequency, hemoglobin, and severity. RESULTS: The results were categorized by the geographical altitude of origin of children under 0 to 59 months of age and hemoglobin levels according to geographical altitude. Of the sample studied, the frequency of anemia at different geographical altitudes of Arequipa in children under five for the 2017 to 2019 period was: 18.7% at 0 to 999 meters above sea level; 29.6% at 1000 to 1999 meters; 31.6% at 2000 to 2999 meters; 42.9% at 3000 to 3999 meters; and 54.4% at 4000 to 4999 meters. There was a higher prevalence of anemia when the geographic altitude correction factor was used. CONCLUSIONS: A significant statistical relationship (p < 0.05) was observed between the corrected hemoglobin according to the World Health Organization parameters and the altitude at which children with anemia live: the higher the geographical altitude, the greater the anemia in children. Supplementation programs should be included during home visits and at the time of evaluation of children's growth and development.

Childhood anemia in Mexico: A public health problem at all socioeconomic levels

Background: In Mexico, prevalence of anemia in children <5 years of age (preschool) is high at all socioeconomic levels. We undertook this study to analyze the socioeconomic determinants of the prevalence of anemia in preschool children and to explore the reasons why the prevalence is high, even in wealthier households. Methods: We used the National Survey of Health and Nutrition (ENSANUT) 2012 and calculated logistic regression models, considering as explanatory variables socioeconomic characteristics of children and mothers, among others. Models were estimated for all preschoolers and for each tercil of socioeconomic status. Results: The national prevalence of anemia in preschool children is 23.3%; in the lowest tertile it is 26.4%, whereas in the highest tertile it is 20.2%. Variables related to increased risk of anemia in the highest tertile are male children (OR: 1.24), those <2 years of age (OR: 2.31), stunting (OR: 2.01), and mother as the head of the household (OR: 2.06). Conclusions: Although anemia prevalence is higher at poorer socioeconomic levels, it remains high at all socioeconomic levels. Therefore, a general strategy is required to reduce the rate of childhood anemia rather than only the targeted efforts followed so far. Further research is needed.

Pharmacotherapy in Childhood Anemia

Anemia is one of the important causes compromising normal growth, development, and immune function in children. In outpatient clinics, we can see patients with anemia caused by various etiologies, whether congenital or acquired. Most cases of childhood anemia are caused by incomplete supplements of nutrients for erythropoiesis, despite the improved socioeconomic situation. Sometimes we need to treat the underlying diseases to correct the anemia. Also, we have to evaluate the etiology of anemia according to age, and consider medical treatments on the basis of the underlying causes. In this article, the author reviews pharmacotherapy in childhood anemia.