| dc.description.abstract | Anemia represents a substantial problem for children living in areas with limited resources and significant
parasite burden. We performed a cross-sectional study of 254 Kenyan preschool- and early school-age children in a set-
ting endemic for multiple chronic parasitic infections to explore mechanisms of their anemia. Complete venous blood
cell counts revealed a high prevalence of local childhood anemia (79%). Evaluating the potential links between low
hemoglobin and socioeconomic factors, nutritional status, hemoglobinopathy, and/or parasite infection, we identified
age < 9 years (odds ratio [OR]: 12.0, 95% confidence interval [CI]: 4.4, 33) and the presence of asymptomatic malaria
infection (OR: 6.8, 95% CI: 2.1, 22) as the strongest independent correlates of having anemia. A total of 130/155
(84%) of anemic children with iron studies had evidence of iron-deficiency anemia (IDA), 16% had non-IDA; 50/52 of
additionally tested anemic children met soluble transferrin-receptor (sTfR) criteria for combined anemia of inflammation
(AI) with IDA. Children in the youngest age group had the greatest odds of iron deficiency (OR: 10.0, 95% CI: 3.9, 26).
Although older children aged 9–11 years had less anemia, they had more detectable malaria,Schistosoma infection, hookworm, and proportionately more non-IDA. Anemia in this setting appears multifactorial such that chronic inflam-
mation and iron deficiency need to be addressed together as part of integrated management of childhood anemia. | en_US |
