title: Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil.
abstract: Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6-71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2-40.8) and 9.8% (95%CI 7.2-12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7-22.6) and 21.8% (95%CI 17.8-26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2-2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4-3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1-2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.
authors.affiliation: Departamento de Parasitologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, 31270-901, MG, Brazil.
authors.forename: Francisca Helena Calheiros
authors.initials: FH
authors.lastname: Zanin
authors.affiliation: Departamento de Nutrição Clínica e Social, Escola de Nutrição, Universidade Federal de Ouro Preto, Campus Universitário, Ouro Preto, 35400-000, MG, Brazil.
authors.forename: Camilo Adalton Mariano
authors.initials: CA
authors.lastname: da Silva
authors.affiliation: Departamento de Nutrição Clínica e Social, Escola de Nutrição, Universidade Federal de Ouro Preto, Campus Universitário, Ouro Preto, 35400-000, MG, Brazil.
authors.forename: Élido
authors.initials: É
authors.lastname: Bonomo
authors.affiliation: Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Campus JK, Diamantina, 39100-000, MG, Brazil.
authors.forename: Romero Alves
authors.initials: RA
authors.lastname: Teixeira
authors.affiliation: Departamento de Parasitologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, 31270-901, MG, Brazil.
authors.forename: Cíntia Aparecida de Jesus
authors.initials: CA
authors.lastname: Pereira
authors.affiliation: Departamento de Parasitologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, 31270-901, MG, Brazil.
authors.forename: Karina Benatti
authors.initials: KB
authors.lastname: dos Santos
authors.affiliation: Departamento de Alimentos, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, 35400-000, Brazil.
authors.forename: Maria Arlene
authors.initials: MA
authors.lastname: Fausto
authors.affiliation: Departamento de Parasitologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, 31270-901, MG, Brazil.
authors.forename: Deborah Aparecida
authors.initials: DA
authors.lastname: Negrão-Correa
authors.affiliation: Universidade Federal de São João Del-Rei, Campus Centro-Oeste, Divinopolis, 36307-352, MG, Brazil.
authors.forename: Joel Alves
authors.initials: JA
authors.lastname: Lamounier
authors.affiliation: Departamento de Parasitologia, Instituto Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, 31270-901, MG, Brazil; Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Mariângela
authors.initials: M
authors.lastname: Carneiro
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000453:epidemiology* / Q000378:metabolism; D001938:Brazil / Q000453:epidemiology; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000097:blood / Q000453:epidemiology / Q000378:metabolism; D000090463:Iron Deficiencies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein; D005293:Ferritins