title: Epidemiology of anemia among 4- to 17-month-old children living in south central Nepal.
abstract: OBJECTIVE
  To describe the distribution of hemoglobin and prevalence of anemia in Nepali children living in the Terai region by potential risk factors for deficiency.
  
  
  METHODS
  This was a cross-sectional, community-based study of baseline characteristics of children enrolled in a randomized, placebo-controlled clinical trial between January and March 2002. Participants were weighed and measured and had their blood drawn. Their mothers contributed demographic, morbidity, and feeding data.
  
  
  METHODS
  There were 569 4- to 17-month-old children. Statistical models were based on 490 children.
  
  
  RESULTS
  Anemia was prevalent: 58% of the children had a hemoglobin <105 g/l. Iron-deficiency anemia (anemia with erythrocyte protoporphyrin (EP) > or =90 micromol/mol heme) was present in 43% of the children. Severe anemia was rare: less than 2% of the children had a hemoglobin <70 g/l. The mean (s.d.) hemoglobin concentration was 101 (12.5) g/l. Stunting and wasting were prevalent: 30.8% were stunted (length-for-age Z-score <-2) and 18.1% were wasted (weight-for-length Z-score <-2). Bivariate analyses revealed that age, caste, socioeconomic status, dietary diversity, stunting, and underweight were associated with hemoglobin concentration and/or anemia. In multivariate models with and without EP, age and caste were found to be strong predictors of both hemoglobin concentration and anemia.
  
  
  CONCLUSIONS
  Anemia and iron deficiency increased strongly with age and low-caste status among the study children. The data reveal the importance of targeting interventions to children in the first year of life before they become anemic and iron deficient.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. esiegel@jhsph.edu
authors.forename: E H
authors.initials: EH
authors.lastname: Siegel
authors.forename: R J
authors.initials: RJ
authors.lastname: Stoltzfus
authors.forename: S K
authors.initials: SK
authors.lastname: Khatry
authors.forename: S C
authors.initials: SC
authors.lastname: Leclerq
authors.forename: J
authors.initials: J
authors.lastname: Katz
authors.forename: J M
authors.initials: JM
authors.lastname: Tielsch
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000097:blood / Q000453:epidemiology*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class
chemical_list: D006454:Hemoglobins