scholarly journals Micronutrient Deficiencies and Anemia in Children in Mexico: Results From the National Health and Nutrition Survey (ENSANUT)

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 647-647
Author(s):  
Cristina Guitron Leal ◽  
Teresa Shamah-Levy ◽  
Juan RIvera-Dommarco ◽  
Salvador Villalpando ◽  
Vanessa De la Cruz ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin A ◽  
Vitamin B12 ◽  
Serum Ferritin ◽  
National Health ◽  
Vitamin A Deficiency ◽  
Micronutrient Deficiencies ◽  
Serum Retinol ◽  
Nutrition Survey ◽  
Health And Nutrition

Abstract Objectives To examine the burden of anemia and micronutrient deficiencies, and associations between micronutrient status and anemia in children (1–11 y) in Mexico. Methods Data from the National Health and Nutrition Survey (ENSANUT 2018) were analyzed to determine the burden of anemia and micronutrient deficiencies (iron, vitamin B12, vitamin A) in a nationally-representative sample of 4,891 children 1 to 11 years of age (1 to < 5 y: 1,337; 5–11 y: 3,554). Hemoglobin (Hb) was measured via HemoCue and venous blood samples were collected, processed, and stored at < -80°C until analysis. Serum ferritin (SF), C-reactive protein (CRP) and vitamin B12 concentrations were measured via immunoassays. Serum retinol was measured via HPLC. Hemoglobin was adjusted for altitude; anemia (< 5 y: Hb < 11.0 g/dL; 5–11 y: < 11.5 g/dL) and iron deficiency (ID; < 5 y: < 12.0 μg/L; 5–11 y: < 15.0 μg/L) were defined using age-specific cut-offs. Iron insufficiency was defined as SF < 20.0 μg/L, and inflammation as CRP > 5.0 mg/L. Vitamin B12 deficiency and insufficiency were defined as < 148 and < 221 pmol/L, and vitamin A deficiency was defined as retinol < 20 μg/dL. Survey linear and logistic regression were used to examine associations of micronutrient biomarkers with hemoglobin concentrations and odds of anemia. Results Serum ferritin concentrations (β [SE]: 0.0003, p < 0.001) and serum retinol levels (0.0005, p < 0.001) were associated with higher hemoglobin levels, while iron deficiency (–0.57 [0.03], p < 0.001), iron insufficiency (–0.54 [0.02]; p < 0.001), and vitamin A deficiency (–0.53 [0.01], p < 0.0001) were associated with lower hemoglobin levels. In analyses of anemia, the odds of anemia were 11% lower per 10 μg/L increase in serum ferritin (OR [95% CI]: 0.89 [0.84–0.93], p < 0.001) and 34% lower per 10 μg/dL increase in serum retinol (OR: 0.66 [0.57–0.77], p < 0.001), while iron deficiency (OR: 2.22 [1.49–3.29], p < 0.001) and iron insufficiency (OR: 1.74 [1.32–2.30]; p = 0.0001) were associated with higher odds of anemia. Conclusions Findings suggest that the burden of anemia and micronutrient deficiencies are high in children in Mexico, and lower iron and vitamin A status were associated with increased odds of anemia. Funding Sources ENSANUT was funded by The Ministry of Health of Mexico.

scholarly journals Micronutrient Status and Child Growth in Mexico: Results From the 2018 National Health and Nutrition Survey (ENSANUT)

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 674-674
Author(s):  
Ximena Palma Molina ◽  
Julia Finkelstein ◽  
Saurabh Mehta ◽  
Teresa Shamah-Levy ◽  
Juan RIvera-Dommarco ◽  
...  
Keyword(s):  
Vitamin D ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Serum Ferritin ◽  
National Health ◽  
Child Growth ◽  
Nutrition Survey ◽  
Health And Nutrition ◽  
Micronutrient Status ◽  
Z Scores

Abstract Objectives To examine the associations between micronutrient status and child growth, as part of the National Health and Nutrition Survey in Mexico. Methods Data from the National Health and Nutrition Survey (ENSANUT 2018) were analyzed to examine the association between micronutrient status and child growth in 1,656 children 36 to 59 months of age. Micronutrient biomarkers (serum ferritin (SF), vitamin B12, vitamin D, serum zinc) were measured in venous blood samples via immunoassays. Child weight and height were measured using standardized procedures, and indicators weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ), and body mass index (BMI) Z-scores were calculated using the WHO Anthro V3.1 and categorized as per WHO Child Growth Standards. Micronutrient biomarkers were natural logarithmically transformed prior to analyses. Iron deficiency was defined as SF < 12.0 μg/L and iron insufficiency was defined as SF < 20.0 μg/L. Vitamin B12 deficiency and insufficiency were defined as < 148 and < 221 pmol/L, respectively. Vitamin D deficiency was defined as < 50 nmol/L, and zinc deficiency was defined as < 65μg/dL. Survey linear regression models were used to examine associations of micronutrient status with WHO Z-scores. Results Serum ferritin concentrations (β [SE]: 0.096 [0.001], p < 0.0001) and vitamin B12 (0.092 [0.003], p < 0.0001) concentrations were associated with higher WHZ. Vitamin B12 (0.171 [0.004], p < 0.0001), vitamin D (0.358 [0.007], p < 0.0001), and zinc (0.122 [0.006], p < 0.0001) concentrations were associated with higher HAZ. Iron deficiency (β [SE]: -0.469 [0.004], p < 0.0001) and zinc deficiency (-0.203 [0.01], p < 0.0001) were associated with lower WHZ, and vitamin B12 (-0.449 [0.002], p < 0.0001), vitamin D (-0.215 [0.001], p < 0.0001) and zinc (-0.216 [0.01], p < 0.0001) deficiencies were associated with lower HAZ. Conclusions Micronutrient deficiencies of vitamin B12, vitamin D, and zinc were associated with lower linear growth in young children in Mexico. Funding Sources ENSANUT was funded by The Ministry of Health of Mexico.

scholarly journals Anemia and Iron and Vitamin B12 Deficiencies in Children Under 5 in Mexico: Results from the National Health and Nutrition Survey (ENSANUT)

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 835-835
Author(s):  
Cristina Güitrón Leal ◽  
Teresa Shamah-Levy ◽  
Juan Rivera Dommarco ◽  
Salvador Villalpando ◽  
Jere Haas ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Serum Ferritin ◽  
Vitamin B12 Deficiency ◽  
Micronutrient Deficiencies ◽  
Nutrition Survey ◽  
Blood Samples ◽  
Health And Nutrition ◽  
B12 Deficiency ◽  
Children Under 5

Abstract Objectives To examine the burden of anemia, iron deficiency, and vitamin B12 deficiency in children under 5 in Mexico. Methods Data from the recently completed National Health and Nutrition Survey (ENSANUT 2018) were analyzed to examine the burden of anemia and micronutrient deficiencies in children under 5 (1 to <5 years). Hemoglobin (Hb) concentrations werequantified in capillary blood samples (n = 3144) via HemoCue.Venous blood samples (n = 1019) were collected, centrifuged, processed, and stored <−80°C until analysis of micronutrient biomarkers. Serum ferritin (SF), C-reactive protein (CRP), and vitamin B12 concentrations were measured via immunoassays. Hemoglobin was adjusted for altitude; anemia was defined as hemoglobin <11.0 g/dL. Iron deficiency was defined as serum ferritin <12.0 µg/L and iron insufficiency was defined as serum ferritin <20.0 µg/L; inflammation was defined as CRP concentrations > 5.0 mg/L (and CRP > 1.0 mg/L). Iron deficiency anemia was defined as hemoglobin <11.0 g/dL and serum ferritin <12.0 μg/L. Vitamin B12 deficiency and vitamin B12 insufficiency were defined as <148.0 and <221.0 pmol/L, respectively. Survey frequency procedures were used to examine the prevalence of anemia and micronutrient deficiencies; survey linear and logistic regression were used to examine associations of micronutrient biomarkers with hemoglobin concentrations and odds of anemia. Results A total of 22.9% of children were anemic in this population. In the biomarker sub-sample, 10.0% of children were iron deficient (SF < 12.0 µg/L), and 29.9% had serum ferritin concentrations <20.0 µg/L. A total of 9.5% of children had CRP concentrations >5.0 mg/L, and 34.7% had CRP > 1.0 mg/L. The prevalence of vitamin B12 deficiency (vitamin B12 < 148.0 pmol/L) was 5.4% and 21.5% of children had vitamin B12 insufficiency (vitamin B12 < 221.0 pmol/L). Conclusions Findings suggest that the burden of anemia and iron and vitamin B12 insufficiency is high in young children in Mexico. Funding Sources ENSANUT was funded by The Ministry of Health of Mexico.

scholarly journals Anemia and Micronutrient Deficiencies in Young Children in Urban Slums of Mumbai, India

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 828-828
Author(s):  
Amy Fothergill ◽  
Samantha Huey ◽  
Jere Haas ◽  
Shobha Udipi ◽  
Padmini Ghugre ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Young Children ◽  
Vitamin B12 ◽  
Serum Ferritin ◽  
Vitamin B12 Deficiency ◽  
Urban Slums ◽  
Severe Anemia ◽  
Micronutrient Deficiencies ◽  
Serum Retinol ◽  
B12 Deficiency

Abstract Objectives To examine the burden of anemia and micronutrient deficiencies among young children living in urban slums of Mumbai, India. Methods Participants were children 10–18 months of age (n = 278) residing in urban slums in Mumbai who were screened as part of a randomized feeding trial of biofortified pearl millet. Venous blood was collected by a pediatric phlebotomist and hemoglobin (Hb) concentrations were assessed via Coulter counter. Samples were processed and stored <−80°C until laboratory analyses. Serum ferritin (SF), vitamin B12, and erythrocyte (RBC) folate concentrations were analyzed via chemiluminescence. C-reactive protein (CRP) was analyzed by nephelometry, α-1 acid glycoprotein (AGP) was analyzed by spectrophotometry, and serum retinol was evaluated via HP-LC. Serum ferritin and serum retinol levels were adjusted for inflammation using methods proposed by Thurman. Anemia and severe anemia were defined as Hb < 11.0 g/dL and Hb < 7.0 g/dL. Iron deficiency (ID) was defined as SF < 12.0 µg/L, iron insufficiency was defined as SF < 20.0 µg/L, and inflammation was defined as CRP > 5.0 mg/L. Iron deficiency anemia was defined as Hb < 11.0 g/dL and SF < 12.0 µg/L. Vitamin A deficiency was defined as serum retinol <20.0 µg/L. Vitamin B12 deficiency and vitamin B12 insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L; folate deficiency was defined as RBC folate <340 nmol/L. Linear and binomial regression models were used to examine associations of micronutrient biomarkers with Hb levels and risk of anemia. Results A total of 75.5% of children were anemic and 2.9% had severe anemia. The prevalence of iron deficiency was 61.4% (69.5% after Thurman adjustment), 57.4% of children had IDA, and 9.7% had CRP > 5.0 mg/L. The prevalence of vitamin B12 deficiency was 17.0%, 41.8% of children had vitamin B12 insufficiency, and 19.9% had folate deficiency. Among anemic children, 84.5% had ≥1 micronutrient deficiency and 22.7% had ≥ 2 micronutrient deficiencies. Iron deficiency (RR: 2.15; 95% CI: 1.55, 2.99; P < 0.001), and vitamin B12 deficiency (RR: 1.32; 95% CI: 1.09, 1.60; P < 0.01) were associated with significantly increased risk of anemia. Conclusions Findings indicate that the burden of anemia, iron deficiency, and vitamin B12 insufficiency were high in young children in Mumbai, India. Funding Sources Harvest Plus; AF was supported by the National Institutes of Health.

scholarly journals Micronutrient Deficiencies, Over- and Undernutrition, and Their Contribution to Anemia in Azerbaijani Preschool Children and Non-Pregnant Women of Reproductive Age

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1483 ◽  
Author(s):  
James Wirth ◽  
Tamerlan Rajabov ◽  
Nicolai Petry ◽  
Bradley Woodruff ◽  
Nafisa Shafique ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Vitamin A ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Vitamin A Deficiency ◽  
Deficiency Anemia ◽  
Micronutrient Deficiencies ◽  
Folate And Vitamin B12

Data on the nutritional situation and prevalence of micronutrient deficiencies in Azerbaijan are scarce, and knowledge about anemia risk factors is needed for national and regional policymakers. A nationally representative cross-sectional survey was conducted to assess the prevalence of micronutrient deficiencies, over- and undernutrition, and to disentangle determinants of anemia in children and women in Azerbaijan. The survey generated estimates of micronutrient deficiency and growth indicators for children aged 0–59 months of age (6–59 months for blood biomarkers) and non-pregnant women 15–49 years of age. Questionnaire data, anthropometric measurements, and blood samples were collected to assess the prevalence of under- and over-nutrition, anemia, iron deficiency, and iron deficiency anemia, in both groups. In children only, vitamin A deficiency and zinc deficiency were also assessed. In women only, folate and vitamin B12 deficiencies and vitamin A insufficiency were assessed. In total, 3926 household interviews were successfully completed with a response rate of 80.6%. In the 1455 children, infant and young child feeding practices were relatively poor overall; the prevalence of wasting and stunting were 3.1% and 18.0%, respectively; and 14.1% of children were overweight or obese. The prevalence of anemia was 24.2% in 6–59 months old children, the prevalence of iron deficiency was 15.0% in this age group, and the prevalence of iron deficiency anemia was 6.5%. Vitamin A deficiency was found in 8.0% of children, and zinc deficiency was found in 10.7%. Data from 3089 non-pregnant women 15–49 years of age showed that while undernutrition was scarce, 53% were overweight or obese, with increasing prevalence with increasing age. Anemia affected 38.2% of the women, iron deficiency 34.1% and iron deficiency anemia 23.8%. Vitamin A insufficiency was found in 10.5% of women. Folate and vitamin B12 deficiency were somewhat more common, with prevalence rates of 35.0% and 19.7%, respectively. The main risk factors for anemia in children were recent lower respiratory infection, inflammation and iron deficiency. In women, the main risk factors for anemia were iron deficiency and vitamin A insufficiency. Anemia is a public health problem in Azerbaijani children and women, and additional efforts are needed to reduce anemia in both groups.

scholarly journals Isolated and combined prevalence of anemia, vitamin A deficiency and zinc deficiency in preschool children 12-72 months for the government of Paraíba

2014 ◽  
Vol 27 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Dixis Figueroa Pedraza ◽  
Márcia Cristina Sales
Keyword(s):  
Vitamin A ◽  
Zinc Deficiency ◽  
School Children ◽  
Vitamin A Deficiency ◽  
Serum Zinc ◽  
Nutritional Deficiencies ◽  
Simultaneous Occurrence ◽  
Micronutrient Deficiencies ◽  
Serum Retinol ◽  
Prevalence Of Anemia

OBJECTIVE: To estimate the isolated and combined prevalence of anemia, vitamin A deficiency and zinc deficiency in pre-school children, as well as the distribution of isolated deficiencies according to gender, age and prior supplementation with vitamin A. METHODS: Cross-sectional study with pre-school children in the state of Paraíba, Brazil. Analysis of the average concentrations of hemoglobin, serum retinol and serum zinc, according to gender, age and previous vitamin A supplementation of children were carried out as well as the risk of simultaneous occurrence of micronutrient deficiencies in the presence of these deficiencies. RESULTS: The prevalence of anemia, vitamin A deficiency and zinc deficiency were 15.4%, 23.3% and 13.8%, respectively. The anemia was significantly associated with age (p<0.01). Children previously supplemented by vitamin A had higher serum retinol concentrations than children without supplements, an effect that was not observed for concentrations of hemoglobin or serum zinc. The prevalence of anemia associated with vitamin A deficiency was 5.8%, with the chance of vitamin A deficiency and anemia coexist 2.21 times (95%CI=1.03-4.84) higher in the case of vitamin A deficiency or anemia rather than in the absence of these conditions. CONCLUSION: The high prevalence of micronutrient deficiencies which are important in child growth, as well as the coexistence of nutritional deficiencies, point out the need to strengthen nutrition intervention strategies that consider this issue.

Anaemia, iron status and vitamin A deficiency among adolescent refugees in Kenya and Nepal

2006 ◽  
Vol 9 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Bradley A Woodruff ◽  
Heidi Michels Blanck ◽  
Laurence Slutsker ◽  
Susan T Cookson ◽  
Mary Kay Larson ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Iron Status ◽  
Risk Groups ◽  
Refugee Camps ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Displaced Populations ◽  
Adolescent Refugees

AbstractObjectiveTo investigate the prevalence of anaemia (haemoglobin < 11.0 to 13.0 g dl−1depending on age and sex group), iron deficiency (transferrin receptor concentration > 8.3 μg ml−1) and vitamin A deficiency (serum retinol < 0.7 μmoll−1) in adolescent refugees.DesignCross-sectional surveys.SettingKakuma refugee camp in Kenya and seven refugee camps in Nepal.SubjectsAdolescent refugee residents in these camps.ResultsAnaemia was present in 46% (95% confidence interval (CI): 42–51) of adolescents in Kenya and in 24% (95% CI: 20–28) of adolescents in Nepal. The sensitivity of palmar pallor in detecting anaemia was 21%. In addition, 43% (95% CI: 36–50) and 53% (95% CI: 46–61) of adolescents in Kenya and Nepal, respectively, had iron deficiency. In both surveys, anaemia occurred more commonly among adolescents with iron deficiency. Vitamin A deficiency was found in 15% (95% CI: 10–20) of adolescents in Kenya and 30% (95% CI: 24–37) of adolescents in Nepal. Night blindness was not more common in adolescents with vitamin A deficiency than in those without vitamin A deficiency. In Kenya, one of the seven adolescents with Bitot's spots had vitamin A deficiency.ConclusionsAnaemia, iron deficiency and vitamin A deficiency are common among adolescents in refugee populations. Such adolescents need to increase intakes of these nutrients; however, the lack of routine access makes programmes targeting adolescents difficult. Adolescent refugees should be considered for assessment along with other at-risk groups in displaced populations.

scholarly journals Reducing micronutrient deficiencies in Pakistani children: are subsidies on fortified complementary foods cost-effective?

2018 ◽  
Vol 21 (15) ◽  
pp. 2893-2906 ◽  
Author(s):  
Simon Wieser ◽  
Beatrice Brunner ◽  
Christina Tzogiou ◽  
Rafael Plessow ◽  
Michael B Zimmermann ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Iron Deficiency ◽  
Vitamin A ◽  
Iodine Deficiency ◽  
Iron Deficiency Anaemia ◽  
Vitamin A Deficiency ◽  
Cost Effective ◽  
Micronutrient Deficiencies ◽  
Deficiency Anaemia ◽  
The Cost

AbstractObjectiveTo estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children.DesignThe study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by comparing the net social cost of price subsidies with the disability-adjusted life years (DALY) averted.SettingDistricts of Faisalabad and Hyderabad in Pakistan.SubjectsHouseholds with 6–23-month-old children stratified by socio-economic strata.ResultsThe lifetime social costs of iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in 6–23-month-old children amounted to production losses of $US 209 million and 175 000 DALY. Poor households incurred the highest costs, yet even wealthier households suffered substantial losses. Wealthier households were more likely to buy FPCF. The net cost per DALY of the interventions ranged from a return per DALY averted of $US 783 to $US 65. Interventions targeted at poorer households were most cost-effective.ConclusionsPrice subsidies on FPCF might be a cost-effective way to reduce the societal costs of micronutrient deficiencies in 6–23-month-old children in Pakistan. Interventions targeting poorer households are especially cost-effective.

scholarly journals Inflammation correction in micronutrient deficiency with censored inflammatory biomarkers

2020 ◽  
Vol 113 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Santu Ghosh ◽  
Anura V Kurpad ◽  
Harshpal S Sachdev ◽  
Tinku Thomas
Keyword(s):  
Iron Deficiency ◽  
Vitamin A ◽  
Empirical Distribution ◽  
Vitamin A Deficiency ◽  
Nutrient Deficiency ◽  
Micronutrient Deficiency ◽  
Probability Method ◽  
Nutrition Survey ◽  
Data Set ◽  
Iron And Zinc

ABSTRACT Background Biomarkers of micronutrient status vary with inflammation, and can be corrected by a regression-based approach [Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA)] using measured concentrations of inflammation biomarkers, e.g., C-reactive protein (CRP) and/or α1-acid-glycoprotein (AGP). However, this is confounded when inflammation is measured with multiple assays with variable limits of detection (LOD) and lower limits of quantification (LLOQ). Objectives We aimed to develop a probability approach for the estimation of prevalence of micronutrient deficiency using the distribution of true serum/plasma micronutrient concentrations in the population. Methods Left-censoring of an inflammation biomarker due to varying values of LOD or LLOQ was addressed by estimating the distribution of the inflammation biomarker at concentrations lower than the LOD and using this for the probability estimation of prevalence of nutrient deficiency. This method was evaluated using 2 publicly available data sets for children &lt;5 y old: BRINDA and the Indian Comprehensive National Nutrition Survey. Each data set included measures of serum ferritin (SF), vitamin A, zinc, and CRP measured using different assays with variable LLOQs. Results The empirical distribution of SF after correction for CRP and AGP by the BRINDA method was comparable with the estimated probability distribution of SF, yielding similar estimates of iron deficiency prevalence when evaluated in the BRINDA data (17.4%; 95% CI: 15.2%, 19.7% compared with 16.8%; 95% CI: 13.9%, 20.0%; BRINDA compared with the probability method). The BRINDA method–adjusted iron deficiency prevalence was linearly associated with the proportion of left-censored CRP data, whereas these were not associated in the probability method. In the Indian survey data, estimates of prevalence of iron and zinc deficiency were comparable but vitamin A deficiency was lower by the probability method (17.6%; 95% CI: 16.7%, 20.2% compared with 15.7%; 95% CI: 15.2%, 16.3%; BRINDA compared with the probability method). Conclusions The proposed probability method is a robust alternate approach to the estimation of the prevalence of nutrient deficiency with left-censored inflammation biomarker data.

scholarly journals Anemia and Iron, Vitamin B12, and Folate Deficiencies in Women of Reproductive Age in Ecuador: Results from the Ecuadorian National Health and Nutrition Survey (P10-027-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Julia Finkelstein ◽  
Cristina Guitron Leal ◽  
Winnie Chu ◽  
Jesse Krisher ◽  
Jere Haas ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Pregnant Women ◽  
Vitamin B12 Deficiency ◽  
Reproductive Age ◽  
Serum Folate ◽  
Micronutrient Deficiencies ◽  
Women Of Reproductive Age ◽  
Nutrition Survey ◽  
Health And Nutrition ◽  
Iron Deficient

Abstract Objectives To examine the burden of anemia and deficiencies of iron, vitamin B12, and folate in women of reproductive age (WRA) in Ecuador. Methods Data from the 2012 Ecuadorian National Health and Nutrition Survey (ENSANUT-ECU) were analyzed to examine the burden of anemia and micronutrient deficiencies among 7658 women of reproductive age (12–49 y; n = 7383 non-pregnant, n = 275 pregnant). Venous blood samples were collected, and hemoglobin (Hb) was assessed viathe sodium lauryl sulfate method. Samples were centrifuged, processed, and stored < -50ºC until analysis. Serum ferritin (SF), vitamin B12, serum folate, and red blood cell (RBC) folate were measured viachemiluminescence. Hemoglobin was adjusted for altitude; and anemia was defined as Hb <11.0 g/dL in pregnant women and <12.0 g/dL in non-pregnant women. Iron deficiency and insufficiency were defined as SF <15.0 µg/L and <20.0 µg/L, respectively. Vitamin B12 deficiency and insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L; and folate deficiency was defined as serum folate <7.0 nmol/L and RBC folate <342.0 nmol/L. Survey logistic and linear regression were used to examine associations of micronutrients with hemoglobin concentrations and anemia. Results In analyses among non-pregnant women, 11.3% were anemic, 14.4% were iron deficient, and 21.1% had iron insufficiency. A total of 4.3% of women had vitamin B12 deficiency, 23.9% had vitamin B12 insufficiency; and <1% of women were folate deficient. The prevalence of micronutrient deficiencies was higher in pregnant women, compared to non-pregnant women: 31.1% of pregnant women were iron deficient, 43.0% were iron insufficient, 21.3% were vitamin B12 deficient, and 55.4% were vitamin B12 insufficient. In non-pregnant WRA, higher SF (P < 0.0001), vitamin B12 (P < 0.01), and serum folate (P < 0.0001) concentrations were associated with higher Hb concentrations; and higher SF (OR: 0.96, 95% CI: 0.95, 0.97; P < 0.0001) and serum folate (OR: 0.98, 95% CI: 0.97, 0.98; P < 0.0001) concentrations were associated with lower odds of anemia. In pregnant women, SF (P < 0.01) and serum folate (P = 0.002) concentrations were associated with higher hemoglobin concentrations. Conclusions Findings suggest that the burden of anemia, iron deficiency, and vitamin B12 insufficiency is high among women of reproductive age in Ecuador. Funding Sources Not applicable.

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