title: Determinants of Anemia among School-Aged Children in Mexico, the United States and Colombia.
abstract: Anemia affects approximately 25% of school-aged children (SAC-aged 5.00-14.99 years) globally. We determined in three countries the prevalence and determinants of anemia in SAC. Data on sociodemographics, inflammation and nutrition status were obtained from the 2006 Mexican National Nutrition Survey, the 2003-6 US National Health and Nutrition Examination Surveys, and the 2010 Encuesta Nacional de Nutrición Situación Colombia. In the US, vitamin A and iron deficiency (ID) were available only for girls aged 12.00-14.99 years to which our analysis was limited. Associations were evaluated by country using multivariable logistic regression adjusting for confounders and complex survey design. The prevalence of anemia and ID were: Mexico 12% (ID 18%), n = 3660; US 4% (ID 10%), n = 733; and Colombia 4% (ID 9%), n = 8573. The percentage of anemia associated with ID was 22.4% in Mexico, 38.9% in the US and 16.7% in Colombia. In Mexico, anemia was associated with ID (adjusted OR: 1.5, p = 0.02) and overweight (aOR 0.4, p = 0.007). In the US, anemia was associated with black race/ethnicity (aOR: 14.1, p < 0.0001) and ID (aOR: 8.0, p < 0.0001). In Colombia, anemia was associated with black race/ethnicity (aOR: 1.6, p = 0.005), lowest socio-economic status quintile (aOR: 1.8, p = 0.0005), ID (aOR: 2.7, p < 0.0001), and being stunted (aOR: 1.6, p = 0.02). While anemia was uniformly associated with iron deficiency in Mexico, Columbia, and the United States, other measured factors showed inconsistent associations with anemia. Additional data on anemia determinants in SAC are needed to guide interventions.
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA. syedsana@gmail.com.
authors.forename: Sana
authors.initials: S
authors.lastname: Syed
authors.affiliation: Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA. yaw.addo@emory.edu.
authors.forename: O Yaw
authors.initials: OY
authors.lastname: Addo
authors.affiliation: Division of Nutrition and Health, Instituto Nacional de Salud P&#250;blica, Cuernavaca, Morelos 62100, Mexico. vcruz@insp.mx.
authors.forename: Vanessa
authors.initials: V
authors.lastname: De la Cruz-Góngora
authors.affiliation: Department of Nutrition &amp; Food Science, College of Agriculture and Natural Resources, University of Maryland, College Park, MD 20742, USA. Fayrouz.Ashour@gmail.com.
authors.forename: Fayrouz A Sakr
authors.initials: FA
authors.lastname: Ashour
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. tzieg01@emory.edu.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Ziegler
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA. psuchde@emory.edu.|Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA. psuchde@emory.edu.
authors.forename: Parminder S
authors.initials: PS
authors.lastname: Suchdev
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006130:Growth Disorders / Q000453:epidemiology*; D006304:Health Status; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008800:Mexico / Q000453:epidemiology; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D019282:Wasting Syndrome / Q000453:epidemiology*
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein; D005293:Ferritins
keywords: Colombia; Mexico; United States; anemia; iron deficiency; school aged children