Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-17T03:41:33.258Z Has data issue: false hasContentIssue false
  • English
  • Français

Anaemia, iron deficiency and vitamin A status among school-aged children in rural Kazakhstan

Published online by Cambridge University Press:  02 January 2007

Masahiro Hashizume ,
Momoko Chiba ,
Atsuko Shinohara ,
Shigehiro Iwabuchi ,
Satoshi Sasaki ,
Taeko Shimoda ,
Osamu Kunii ,
Wathan Caypil ,
Damir Dauletbaev  and
Akmaral Alnazarova
Masahiro Hashizume*
Affiliation:
Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
Momoko Chiba
Affiliation:
Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan
Atsuko Shinohara
Affiliation:
Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan
Shigehiro Iwabuchi
Affiliation:
Central Research Laboratories, Nippon Zenyaku Kogyo, Koriyama-City, Japan
Satoshi Sasaki
Affiliation:
National Institute of Health and Nutrition, Tokyo, Japan
Taeko Shimoda
Affiliation:
Faculty of Home Economics, Kyushu Women's University, Kitakyushu, Japan
Osamu Kunii
Affiliation:
Research and Programming Division, Economic Cooperation Bureau, Ministry of Foreign Affairs, Tokyo, Japan
Wathan Caypil
Affiliation:
Department of Biochemistry, Kazakh State Medical University, Almaty, Kazakhstan
Damir Dauletbaev
Affiliation:
State Medical Centre, Kzyl-Orda City, Kazakhstan
Akmaral Alnazarova
Affiliation:
Health Care Department, Kzyl-Orda State, Kzyl-Orda, Kazakhstan
*
*Corresponding author: Email masahiro.hashizume@lshtm.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives

To investigate the prevalence of anaemia and iron deficiency and vitamin A status among school-aged children in rural Kazakhstan and identify factors associated with anaemia in this population.

Design

A cross-sectional design.

Setting

School-aged children in rural Kazakhstan.

Subjects

Socio-economic and anthropometric information was collected from 159 school-aged children living in the Kzyl-Orda region of Kazakhstan. Blood samples were collected and the concentrations of haemoglobin (Hb), serum iron, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum retinol and β-carotene, total iron binding capacity (TIBC), transferrin saturation (TS) and other haematological indices were measured.

Results

Among the 159 children, the prevalence of anaemia and iron deficiency defined by the multiple criteria model (SF, TS and EP) was 27% and 13%, respectively. Nine per cent had iron-deficiency anaemia and 21% had serum retinol value <1.05 μmol l−1. Mean SF and serum iron concentrations and TS were significantly lower in anaemic children than in their non-anaemic peers, while TIBC and EP were significantly higher in children with anaemia. Hb was significantly correlated with serum iron and retinol concentrations. Serum retinol and SF concentrations and mean corpuscular volume were significantly correlated with Hb by multiple regression analysis.

Conclusions

Anaemia among school-aged children in rural Kazakhstan appears to be related to iron indices and vitamin A status.

Keywords

AnaemiaIron deficiencyVitamin ASerum retinolSchool-aged childrenKazakhstan
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 6 , September 2005 , pp. 564 - 571
Copyright
Copyright © The Authors 2005

References

1Grantham-McGregor, S, Ani, C. A review of studies on the effect of iron deficiency on cognitive development in children. Journal of Nutrition 2001; 131(Suppl. 2): 649S–68S.CrossRefGoogle ScholarPubMed
2National Institute of Nutrition (Kazakhstan) & Macro International Inc. Kazakhstan Demographic and Health Survey, 1995. Calverton, MD: National Institute of Nutrition and Macro International Inc., 1996.Google Scholar
3World Health Organization (WHO). Complementary Feeding and the Control of Iron Deficiency Anaemia in the Newly Independent States. Copenhagen: WHO Regional Office for Europe, 2000.Google Scholar
4Hashizume, M, Kunii, O, Sasaki, S, Shimoda, T, Wakai, S, Mazhitova, Z, et al. Anemia and iron deficiency among schoolchildren in the Aral Sea region, Kazakhstan. Journal of Tropical Pediatrics 2003; 49(3): 172–7.CrossRefGoogle ScholarPubMed
5Hashizume, M, Shimoda, T, Sasaki, S, Kunii, O, Caypil, W, Dauletbaev, D, et al. Anaemia in relation to low bioavailability of dietary iron among school-aged children in the Aral Sea region, Kazakhstan. International Journal of Food Sciences and Nutrition. 2004; 55(1): 37–43.CrossRefGoogle ScholarPubMed
6Majia, LA, Hodges, RE, Arroyave, G, Viteri, F, Torun, B. Vitamin A deficiency and anemia in Central American children. American Journal of Clinical Nutrition 1977; 30(7): 1175–84.CrossRefGoogle ScholarPubMed
7Bloem, MW, Wedel, M, Egger, RJ, Speek, AJ, Schrijver, J, Saowakontha, S, et al. Iron metabolism and vitamin A deficiency in children in northeast Thailand. American Journal of Clinical Nutrition 1989; 50(2): 332–8.CrossRefGoogle ScholarPubMed
8Mejia, LA, Arroyave, G. The effect of vitamin A fortification of sugar on iron metabolism in preschool children in Guatemala. American Journal of Clinical Nutrition 1982; 36(1): 87–93.CrossRefGoogle ScholarPubMed
9Ahmed, F, Khan, MR, Karim, R, Taj, S, Hyderi, T, Faruque, MO, et al. Serum retinol and biochemical measures of iron status in adolescent schoolgirls in urban Bangladesh. European Journal of Clinical Nutrition 1996; 50(6): 346–51.Google ScholarPubMed
10Ahmed, F, Khan, MR, Islam, M, Kabir, I, Fuchs, GJ. Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh. European Journal of Clinical Nutrition 2000; 54(9): 678–83.CrossRefGoogle ScholarPubMed
11Semba, RD, Bloem, MW. The anemia of vitamin A deficiency: epidemiology and pathogenesis. European Journal of Clinical Nutrition 2002; 56(4): 271–81.CrossRefGoogle Scholar
12World Health Organization (WHO). Measuring Change in Nutritional Status. Guidelines for Assessing the Nutritional Impact of Supplementary Feeding Programmes for Vulnerable Groups. Geneva: WHO, 1983.Google Scholar
13United Nations Children's Fund (UNICEF). How to Weigh and Measure Children: Assessing the Nutritional Status of Young Children in Household Surveys. New York: United Nations Department of Technical Co-operation for Development and Statistical Office, UNICEF, 1986.Google Scholar
14Hamill, PV, Drizd, TA, Johnson, CL, Reed, RB, Roche, AF, Moore, WM. Physical growth: National Center for Health Statistics percentiles. American Journal of Clinical Nutrition 1979; 32(3): 607–29.CrossRefGoogle ScholarPubMed
15World Health Organization (WHO). The Use and Interpretation of Anthropometry. Technical Report Series. Geneva: WHO, 1995.Google Scholar
16Must, A, Dallal, GE, Dietz, WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. American Journal of Clinical Nutrition 1991; 53(4): 839–46.CrossRefGoogle Scholar
17Must, A, Dallal, GE, Dietz, WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness – a correction. American Journal of Clinical Nutrition 1991; 54: 773.CrossRefGoogle Scholar
18Miller, KW, Yang, CS. An isocratic high-performance liquid chromatography method for the simultaneous analysis of plasma retinol, α-tocopherol, and various carotenoids. Analytical Biochemistry 1985; 145(1): 21–6.CrossRefGoogle ScholarPubMed
19Sakai, K, Takeuchi, S, Araki, T, Ushio, K, Kondo, M, Chiba, M, et al. Determination of protoporphyrins in blood using HPLC – standardization of protoporphyrins and interlaboratory comparison of analyses. Japanese Journal of Industrial Health 1992; 34: 236–42.Google ScholarPubMed
20Gibson, R. Assessment of iron status. In: Gibson, R ed. Principles of Nutritional Assessment. New York: Oxford University Press, 1990: 349–76.Google Scholar
21De Maeyer, EM. Preventing and Controlling Iron Deficiency Anemia through Primary Health Care. A Guide for Health Administrators and Programme Managers. Geneva: World Health Organization, 1989.Google Scholar
22Thurnham, DI, McCabe, GP, Northrop-Clewes, CA, Nestel, P. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis. Lancet 2003; 362(9401): 2052–8.CrossRefGoogle ScholarPubMed
23Hulthen, L, Lindstedt, G, Lundberg, PA, Hallberg, L. Effect of a mild infection on serum ferritin concentration – clinical and epidemiological implications. European Journal of Clinical Nutrition 1998; 52(5): 376–9.CrossRefGoogle ScholarPubMed
24Cook, JD, Finch, CA, Smith, NJ. Evaluation of the iron status of a population. Blood 1976; 48(3): 449–55.CrossRefGoogle ScholarPubMed
25Stockman, JA 3rd, Weiner, LS, Simon, GE, Stuart, MJ, Oski, FA. The measurement of free erythrocyte porphyrin (FEP) as a simple means of distinguishing iron deficiency from β-thalassemia trait in subjects with microcytosis. Journal of Laboratory and Clinical Medicine, 1975; 85(1): 113–9.Google ScholarPubMed
26United Nations Children's Fund (UNICEF)/World Health Organization (WHO). Prevention and Control of Iron Deficiency Anemia in Women and Children. Report of the UNICEF/WHO Regional Consultation. Geneva: WHO, 1999.Google Scholar
27Molla, A, Badruddin, SH, Khurshid, M, Molla, AM, Rahaman, FN, Durrani, S, et al. Vitamin A status of children in the urban slums of Karachi, Pakistan, assessed by clinical, dietary, and biochemical methods. American Journal of Tropical Medicine and Hygiene 1993; 48(1): 89–96.CrossRefGoogle ScholarPubMed
28Ahmed, F, Barua, S, Mohiduzzaman, M, Shaheen, N, Bhuyan, MA, Margetts, BM, et al. Interactions between growth and nutrient status in school-age children of urban Bangladesh. American Journal of Clinical Nutrition 1993; 58(3): 334–8.CrossRefGoogle ScholarPubMed
29Mohanram, M, Kulkarni, KA, Reddy, V. Hematological studies in vitamin A deficient children. International Journal for Vitamin and Nutrition Research 1977; 47(4): 389–93.Google ScholarPubMed
30Semba, RD, Muhilal West, KP Jr, Winget, M, Natadisatra, G, Scott, A, et al. Impact of vitamin A supplementation on hematological indicators of iron metabolism and protein status in children. Nutrition Research 1992; 34: 469–78.CrossRefGoogle Scholar
31Wolde-Gebriel, Z, Gebru, H, Fisseha, T, West, CE. Severe vitamin A deficiency in a rural village in the Hararge region of Ethiopia. European Journal of Clinical Nutrition 1993; 47(2): 104–14.Google Scholar
32van Stuijvenberg, ME, Kruger, M, Badenhorst, CJ, Mansvelt, EP, Laubscher, JA. Response to an iron fortification programme in relation to vitamin A status in 6–12-year-old school children. International Journal of Food Sciences and Nutrition 1997; 48(1): 41–9.CrossRefGoogle Scholar
33Mejia, LA, Chew, F. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. American Journal of Clinical Nutrition 1988; 48(3): 595–600.CrossRefGoogle Scholar
34Suharno, D, West, CE, Muhilal Karyadi, D, Hautvast, JG. Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet 1993; 342(8883): 1325–8.CrossRefGoogle ScholarPubMed
35Ahmed, F, Khan, MR, Jackson, AA. Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh. American Journal of Clinical Nutrition 2001; 74(1): 108–15.CrossRefGoogle ScholarPubMed
36Tanumihardjo, SA. Vitamin A and iron status are improved by vitamin A and iron supplementation in pregnant Indonesian women. Journal of Nutrition 2002; 132(7): 1909–12.CrossRefGoogle ScholarPubMed
37Gleason, GR, Sharmanov, T. Anemia prevention and control in four central Asian republics and Kazakhstan. Journal of Nutrition 2002; 132(Suppl. 4): 867S–70S.CrossRefGoogle ScholarPubMed