Is the prevalence of anemia in children living at high altitudes real? An observational study in Peru
Corresponding Author
Benita Maritza Choque-Quispe
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
These authors contributed equally to this work.
Address for correspondence: Dulce E. Alarcón-Yaquetto, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 15102, Peru. [email protected]
Search for more papers by this authorDulce E. Alarcón-Yaquetto
Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
Instituto de Investigaciones en Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
These authors contributed equally to this work.
Search for more papers by this authorWilber Paredes-Ugarte
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorArturo Zaira
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorAdelayda Ochoa
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorGustavo F. Gonzales
Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
Instituto de Investigaciones en Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
Search for more papers by this authorCorresponding Author
Benita Maritza Choque-Quispe
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
These authors contributed equally to this work.
Address for correspondence: Dulce E. Alarcón-Yaquetto, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 15102, Peru. [email protected]
Search for more papers by this authorDulce E. Alarcón-Yaquetto
Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
Instituto de Investigaciones en Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
These authors contributed equally to this work.
Search for more papers by this authorWilber Paredes-Ugarte
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorArturo Zaira
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorAdelayda Ochoa
Facultad de Ciencias de la Salud, Universidad Nacional del Altiplano, Puno, Peru
Search for more papers by this authorGustavo F. Gonzales
Laboratorio de Endocrinología y Reproducción, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
Instituto de Investigaciones en Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
Search for more papers by this authorAbstract
Anemia diagnosis in populations residing at high altitude (HA) involves an adjustment of hemoglobin (Hb) values owing to the increase in its concentration with altitude. The suitability of the adjustment has been questioned since Hb concentrations depend on how adapted a population is to HA. In Peru, anemia in preschool children (PSC) is a matter of severe public concern for its high rates; in the city of Puno (∼3800 MASL), for example, 67.7% of children under 3 years are diagnosed with anemia. Here, we conducted an observational study in PSC living at different altitudes in Puno to assess Hb, iron status, and the suitability of altitude-adjusted Hb values in defining iron deficiency anemia. After adjusting Hb, 65.66% of the population had anemia, while only 4.8% of PSC had anemia when using unadjusted Hb. Receiver-operating characteristic curves using total body iron (TBI) as a marker of iron status are presented. In the 36- to 59-month age group, unadjusted Hb performed better than altitude-adjusted Hb. In the 6- to 35-month age group, anemia (adjusted or unadjusted) was not associated with TBI. We conclude that Hb adjustment by altitude is not appropriate. Anemia at an early age is not entirely attributable to iron deficiency.
Supporting Information
Filename | Description |
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nyas14356-sup-0001-Figure.docx561.3 KB | Figure S1. ROC curves for anemia defined with the adjusted-Hb by altitude according to the WHO recommendation (Adj Hb) (B), or defined with unadjusted Hb (Hb) (A) in children from 36 to 59 months without inflammation. |
nyas14356-sup-0002-Tables.docx40.6 KB | Table S1. Distribution of age, unadjusted hemoglobin (g/dL), adjusted hemoglobin (g/dL) of the groups of preschool children (PSC) from Puno, Peru according to the altitude of residence. Table S2. Age, the altitude of residence, IL-6 and IL-8, hemoglobin, hepcidin, total body iron (TBI), and erythropoietin levels and rates of preschool children (PSC) with higher IL-6 levels, anemia, corrected anemia, and iron deficiency (TBI < 0 mg/kg) according to the presence or absence of inflammation. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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