Characterization of anemia and iron deficiency in 6–12 month old infants from rural India

Abstract

Determining anemia and iron deficiency (ID) prevalence estimates in infants using stringent criteria are a critical step in designing effective prevention strategies. The objective was to characterize biomarkers of iron, folate and vitamin B12 status and inflammatory marker C ‐ reactive protein (CRP) in 6–12 month old infants. We enrolled 497 infants from rural Andhra Pradesh, India as part of an interventional study of simultaneous early learning stimulation and at‐home micronutrient fortification. At baseline, blood was collected from 483 infants. ID was diagnosed based on ferritin <12 μg/L or serum transferrin receptor (sTfR) >;2.5 mg/L and ID with hemoglobin (Hb) <11 g/dL as iron deficiency anemia (IDA) and cases which did not fit into the above categories as indeterminant. Prevalence of anemia was 67%: iron replete infants accounted for 27%; IDA 52%; ID 6% and indeterminant cases 15%. The prevalence of folate and vitamin B12 deficiency was <1% and 19%, respectively. Mean folate status was comparable among groups while vitamin B12 status was significantly lower in IDA compared to normal infants. Indeterminant infants exhibited significantly lower Hb and sTfR and higher ferritin and CRP compared to normal infants. These findings suggest that IDA is highly prevalent among infants. Research support: Mathile Institute & Micronutrient Initiative