Anemia In Children Research Articles

Blood Lead Levels and Their Association with Iron Deficiency and Anemia in Children.

Lead is a ubiquitous and neurotoxic heavy metal particularly harmful to children, who are more susceptible than adults to its toxic effects. The prevalence of lead poisoning and iron deficiency (ID) is high in socioeconomically vulnerable child populations, negatively affecting neurocognitive development in children. Although numerous studies have shown the association between blood lead levels (BLL) and ID, the issue remains controversial. Here, we aimed to identify the association between BLL and iron nutritional status in children. We conducted an analytical cross-sectional study of healthy children aged 1-6 y attending periodic health checks in primary healthcare units from La Plata and its surroundings, Buenos Aires, Argentina, between 2012 and 2017. We performed anthropometric evaluations and determined BLL, hemoglobin (Hb) and serum ferritin levels. Blood lead levels ≥ 5µg/dL were defined as elevated BLL; ferritin levels < 12 ng/ml were considered ID; Hb levels < 11g/dL (< 11.5g/dL for children ≥ 5 y) were defined as anemia. Data were analysed using Mann Whitney test, Student´s t-test, chi-square test and logistic regression. The R package (v. 4.2.2.) was used for the statistical analysis of data. The sample included 392 children (mean age, 2.4 ± 1.4 y; 44.6% females). The prevalence of elevated BLL, ID and anemia was 8.7%, 26.3% and 31.8%, respectively. We found a significant association between elevated BLL and ID (odds ratio [OR], 95% confidence interval [CI]: 3.16 (1.50, 6.63)). The prevalence of elevated BLL was 16.2% and 5.8% in children with and without ID, respectively (p = 0.003). We also found association between elevated BLL and anemia (OR 95% CI: 3.03 (1.49, 6.29)). In conclusion, blood lead levels ≥ 5µg/dL were significantly associated with ID and anemia in children aged 1-6 years.

The Frequency and Causes of Erythropoietin-Resistant Anemia in Children Under Dialysis

The Frequency and Causes of Erythropoietin-Resistant Anemia in Children Under Dialysis

IJCM_66A: Beliefs, perceptions, and practices of mothers of under-five children towards control of childhood anemia in selected urban and rural areas of Puducherry – An explanatory mixed methods study.

Background: Anaemia is a significant public health issue that affects different age groups, mainly children under five. A mother’s knowledge, attitudes, and practices are often associated with the health status of children Objective: The study aimed to assess mothers’ knowledge, attitudes, and practices towards childhood anaemia control, the status of IFA consumption among under-five children in Puducherry, and explore socio-cultural beliefs and perceptions about childhood anaemia. Methodology: A community-based cross-sectional study was conducted in selected urban and rural areas, where Anganwadi centres were selected through simple random sampling. A pre-validated semi-structured questionnaire was used to collect data from mothers of children under five. In-depth interviews were conducted to explore socio-cultural beliefs and perceptions of childhood anaemia. Results: According to the study, the majority of participants were aware of the causes (89.5%) and symptoms (90.3%) of anaemia, as well as the consequences during pregnancy (80.7%) and child growth risks (72.3%). However, the knowledge of health risks to the child if the mother is anaemic during pregnancy was known to only 64.0% of mothers. While most participants were aware of iron-rich foods, the knowledge of the practice of providing these foods was less widespread. Additionally, only 28.4% of children receive adequate IFA supplements. Conclusion: Though knowledge, attitude, and practices have improved, they are still inadequate to reduce the anaemia burden. Only one in three children received adequate IFA supplements. Adherence to the correct dosage of IFA supplementation needs further awareness and emphasis.

Spatially Weighted Multinomial Modelling of Comorbidity of Anaemia and Malaria among Under-Five Children in Nigeria

Children in sub-Saharan African countries, especially Nigeria, continue to suffer increased mortality owing to comorbidity of infections such as anaemia and malaria, which are known to epidemiologically overlap. In order to examine the risk factors and spatial patterns of comorbidity of anaemia and malaria using the 2021 Nigeria Malaria Indicator Survey (NMIS), a multinomial logit model was extended by incorporating a spatially weighted random effect. The impact of climatic variation on the childhood disease comorbidity was explored by weighting the spatial structured component based on the 2021 NMIS average cluster temperature of each state in Nigeria. A number of spatially weighted geo-additive models were fitted and compared using deviance information criterion. Inference was fully Bayesian, and an Intrinsic Conditional Autoregressive prior was used for structured random effects. Based on the map generated from the best-fitted model, which unveiled states that are more susceptible to the risk of disease comorbidity, the average temperature used as a weighting factor, however, has a strong relationship with the spatial pattern of disease comorbidity. States with low temperatures have a higher risk of comorbidity of anaemia and malaria compared to states with higher average temperatures. Area of residence, level of education of the mother, economic status of the mother, and owning mosquito-treated nets were identified as the significant risk factors associated with the disease comorbidity. Findings from this study will be helpful to policymakers and health authorities in their effort to combat the comorbidity of childhood anaemia and malaria, thereby reducing child mortality in Nigeria.

Factors Associated with Anaemia in Under-five Children in Zambia; Secondary Analysis of the 2021 Malaria Indicator Survey Data

Introduction: Anaemia is one of the major public health concerns in many developing countries including Zambia. Unless it is acute, the consequences of anaemia are not immediate but have long-term debilitating effects such as growth and intellectual retardation. As such it does not receive the necessary attention it deserves. This study aimed to assess the prevalence and associated factors of anaemia in under-five children in Zambia.&#x0D; Methods: This study was a secondary analysis of the 2021 Malaria Indicator Survey. We extracted data from the datasets at the National Malaria Elimination Centre after obtaining permission from the Ministry of Health. The extracted data was analysed in STATA 14, summarised in frequencies, cross-tabulations between independent variables and the outcome and multivariable logistic regression was used to assess the associations between variables and anaemia.&#x0D; Findings: The prevalence of anaemia was found to be 53.8%. Anaemia was found to be associated more with children below one year compared to older children, children whose household heads had no or only have primary education compared to those with secondary or tertiary education and in the northern parts of the country such as Luapula and Northern provinces compared to the southern province. Further anaemia was more common in those with malaria than those without malaria and those with febrile illnesses than those without febrile illnesses. In addition, anaemia was less common in those who slept under insecticide-treated nets.&#x0D; Conclusion: Anaemia in Zambia has been found to be higher than the average in Southern Africa, it is associated with younger age groups, poverty conditions and where diseases like malaria and other febrile illnesses are more common than where they are not. The use of interventions like insecticide-treated nets is associated with reduced prevalence of anaemia.

Etiologies and Outcomes of Normocytic Anemia in Children

To characterize the evaluation and outcomes of children referred to pediatric hematology for normocytic anemia. Retrospective cohort study of children aged 0 to 21 years referred to a tertiary pediatric hematology clinic for normocytic anemia from 2019 through 2021. Normocytic anemia was defined as a low hemoglobin and normal mean corpuscular volume, per the referring laboratory reference range. Two-hundred seventy-one patients (48% female, median age 5.4 years) were included. The most common hematologic diagnoses included iron deficiency (n=90, 33%), statistical anemia (n=64, 24%), transient marrow suppression (n=36, 13%), and transient erythroblastopenia of childhood (TEC, n=19, 7%). There were 17 (6%) patients in whom anemia was thought to be secondary to a non-hematologic disorder and therefore were referred to another pediatric specialty. Sixteen patients (6%) had anemia which spontaneously resolved without an underlying etiology being identified. Aside from iron deficient patients, 35 (13%) had diagnoses requiring ongoing hematology care including TEC, hemolytic anemia, Diamond Blackfan Anemia, and abnormal beta globin traits. Two-hundred-fifty-one patients (93%) were discharged from hematology care after a median of 25 days (range 0-2124 days). Pediatric patients with normocytic anemia have diverse underlying etiologies with iron deficiency being most common. These data support initial management within the primary care setting including assessment of a serum ferritin, iron panel, and reticulocyte count, with only a subset of patients requiring ongoing subspecialty care.

Study of the most prevalent parasitic diseases especially pinworm among children aged (5-12years) in various areas of Dhi Qar Governorate

Objective: This study included investigating the quality and prevalence of external and internal (intestinal) parasites among children in various regions at Dhi Qar government. The current study also aimed to focus on and find out the relationship between pinworm infection and appendicitis.&#x0D; Methods: The study was conducted during the period between February and July in the year 2023. The study included 100 patients infected with one or more types of ecto or intestinal parasites of both sexes, their ages ranged from 5 to 12 years. A clinical examination was performed for them by a pediatrician and they were sent to the laboratory to conduct the necessary laboratory tests.&#x0D; Results: The current study revealed that a number of parasitic infections, whether external or internal, are associated with anemia and malnutrition in children, in addition to poor psychological condition. Some cases of parasitic worms, especially pinworms, were associated with acute appendicitis. A number of histopathological changes were found after examining the excised organ histologically These changes included necrosis of the sub mucosal layer, erosion of the mucosal lining, and an abundance of fibroblasts in the muscle and serum layers.&#x0D; Conclusion: Acute appendicitis due to E. vermicularis is a very rare occurrence. The histopathological analysis of resected specimens should pay special attention to search for this parasite for adequate post-operative treatment of patients.

Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among Children Living at High Elevation in Cusco, Peru.

Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3-16 years of age attending public schools were invited to participate. We enrolled children 3-16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35-3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2-3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2-3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82-0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59-0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91-0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26-0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.

Effects of short birth interval on child malnutrition in the Asia-Pacific region: Evidence from a systematic review and meta-analysis.

Child malnutrition remains a significant concern in the Asia-Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia-Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia-Pacific region between September 2000 and May 2023. Fixed-effects or random-effects meta-analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta-analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97-1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88-6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national-level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia-Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality.

The Role of Reticulocyte Hemoglobin Content in Diagnosing Iron Deficiency in Childhood Cancer

Abstract Background The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in children with cancer is not well studied. The detection of ID and IDA using sensitive laboratory tools may facilitate early diagnosis and treatment in this cohort. In this regard, reticulocyte hemoglobin (Ret-He) content serves as a cost-effective measurement that remains unaffected by inflammation, unlike the ferritin test. Aim The objective of this study is to analyze the role of Ret-He as a diagnostic tool to identify functional and absolute ID and IDA in children with cancer. Methods We conducted a cross-sectional study in children aged 0 to 18 years. Blood samples were collected to compare Ret-He values with iron status, reflected by hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron (SI), total iron binding capacity (TIBC), and ferritin and transferrin saturation. The overall discriminative power of Ret-He in detecting ID and IDA was assessed using receiver operating characteristic analysis. Results Of the 135 children included in the study, 58 (43.0%) had anemia. Among them, 20 (14.8%) had IDA (8 [5.9%] absolute and 12 [8.9%] functional), while 25 (18.5%) had ID (16 [11.9%] absolute and 9 [6.7%] functional). The Ret-He value was significantly related to iron status (p ≤ 0.002). Ret-He was also shown to have a significant correlation with the abovementioned hematological parameters (p = 0.000), except TIBC. Multivariate analysis revealed a significant relationship between Hb (p = 0.051), MCH (p = 0.000), and MCHC (p = 0.001) and Ret-He. Ret-He values of 33.7, 32.7, 32.4 and 28.6 pg were established as optimal cut-off values to identify functional ID, absolute ID, functional IDA, and absolute IDA, respectively. Conclusion Ret-He is a reliable diagnostic tool for absolute and functional IDA in children with cancer.

Associative Patterns Between Iron Deficiency Anemia and Febrile Seizures in the Five to 60 Months Age Group: A Comprehensive Systematic Review.

Febrile seizures (FS) are commonly seen in younger age groups. The cause of seizures is multifactorial, including viral illnesses, certain vaccines such as MMR (measles, mumps, rubella), family history of FS, and certain mineral deficiencies like zinc. Iron deficiency anemia (IDA) is the most common cause of anemia in children of the same age group. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This review aimed to investigate the correlation between IDA and fever convulsions. A systematic literature search was conducted using PubMed and Google Scholar databases for studies published between January 2013 and September 2023. The following keywords were used to search the articles: "children", "febrile seizures", and "iron deficiency anemia", using all possible combinations and using the word "and" between them. Following the inclusion and exclusion criteria application, we included 23 case-control studies written in the English language in this study. Quality assessment of studies was done using the Newcastle Ottawa Scale.

Aetio-pathological profile of anaemic children belonging to upper socioeconomic society in a tertiary care hospital of North India

Introduction: Anaemia is a major public health problem especially in the preschool age group. It is rampant even in children of upper and middle classes of the society.Objectives: To study the aetio-pathology of anaemia in children belonging to upper and upper middle socio-economic scale and to correlate it with their nutritional status. Method: It was a cross-sectional descriptive study on 165 preschool children aged 6-59 months who presented with pallor on clinical examination. They were advised to undergo a complete haemogram and further specific tests as required. Results: The most common cause of anaemia was nutritional, including iron deficiency (92%), combined iron and B12 deficiency (2%) and isolated B12 deficiency (0.6%). Thalassaemia was the next common cause (3%) followed by B-acute lymphoblastic leukaemia (1%) and microangiopathic haemolytic anaemia (0.6%). Maternal education and nutritional awareness had positive correlation with anaemia. Majority of children were normally nourished despite being anaemic, However, undernourished children were more severely anaemic. Conclusions: Nutritional anaemia is the commonest cause of anaemia even in children belonging to higher socio-economic classes.

Anemia and its associated factors in children aged 2-5 years in slum area of Multan.

Objective: To determine the prevalence of anemia among children aged 2-5 years in slum area of Multan and also to detect the associated factors of this condition. Study Design: Descriptive Cross Sectional Study. Setting: Slum Area (Jahangirabad) of Multan. Period: February 2023 to March 2023. Material &amp; Methods: A total of 369 children of 2-5 years of age, not suffering from psycho-motor retardation, hormonal disorders, chronic debilitating diseases, congenital heart diseases, or acute severe illnesses were included in study using non-probability convenient sampling technique. Information was taken by using a pretested questionnaire. Results: The mean age was 3.5 and SD ±2.2. The prevalence of anemia was 55.83% (n=369). About 51.46% of anemic children had mild anemia. There was no gender variation in occurrence of anemia (p = 0.52). There was significant association between mother’s education, occupation and anemia respectively (p = 0.01, 0.00). Conclusion: Anemia is a growing health issue in our new generation and government and health professional should manage this issue.

The effectiveness of albendazole against hookworm infections and the impact of bi-annual treatment on anaemia and body mass index of school children in the Kpandai district of northern Ghana.

The impact of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) (initiated in 2000 in Ghana and ran for 12 years) in mitigating soil-transmitted helminth (STH) infections in LF-endemic areas is unknown. During a 1-year hiatus which ensued between 2011 and 2012, a longitudinal study was conducted to determine GPELF effect on hookworm infections in selected communities involved in the programme since its inception, while measuring the effectiveness of biannual ALB treatments on schoolchildren living in such communities. A total of 399 school children aged 3 to 18 years were randomly selected from four communities in the Kpandai district of northern Ghana. Each presented a single stool sample at baseline, 21 days post-treatment, at the 3rd and 6th months, 21 days post-second intervention (i.e. following sample collection and treatment with ALB in the 6th month), and in the ninth month of the study period. Haemoglobin (hb) levels were also measured at all time points using finger prick blood samples and a URIT digital test kit. Each participant submitting a sample, was treated with a single-dose ALB (400mg) at baseline and in the sixth month. Stool samples were processed by preparing duplicate Kato-Katz slides per sample, and examined by microscopy. The Body Mass Index-for-age z-scores (BAZ) of participants were assessed following the determination of BMIs at each time point by measuring their height and weight with a stadiometer and weighing scale. Overall hookworm prevalences were 25.68% (95% CI = 20.51-31.75) at baseline, 11.18% (95% CI = 7.87-15.41) 21 days post-treatment, 11.78% (95% CI = 8.38-16.11) and 6.95% (95% CI = 4.41-10.43) in the 3rd and 6th months, 0.91% (95% CI = 0.19-2.65) 21 days post-second intervention, and 8.46% (95% CI = 5.62-12.23) in the ninth month. Observed overall faecal egg count reduction rates (ERRs) were 94.21% (95% CI = 81.50%- 100.00%) 21 days after baseline treatment, 97.70% (95% CI = 85.08-100.00) and 96.95% (95% CI = 84.18%- 100.00%) in the 3rd and 6th months, 99.98% (95% CI = 86.42%- 100.00%) 21 days post-second intervention, and 17.18% (95% CI = 14.07%- 20.67%) in the 9th month. Respective cure rates (CRs) were 62.35% (95% CI = 46.71-81.56%), 85.88% (95% CI = 67.32-100.00%), 87.06% (95% CI = 68.36%- 100.00%), 98.82% (95% CI = 78.83%- 100.00%), and 36.36% (95% CI = 9.91%- 93.11%). Additionally, increases in the percent frequency of 'normal hb' (p < 0.01) were observed across the study time points, whilst 'normal BAZ' cases remained high (from 94.87% to 98.87%) throughout the study period. These findings primarily indicate satisfactory effectiveness of ALB which may be maintainable in mass drug administration programmes by the modification of treatment strategies from annual to bi-annual regimes. This could minimize the likelihood of emerging poorly-responding hookworm phenotypes in Ghana. Additionally, a positive impact of bi-annual treatment on participant anaemia status is herein indicated with particular regard to the school children in our cohort.

An Evaluation of Carbon Nanotube-based and Activated Carbon-based Nanocomposites for Fluoride and Other Pollutant Removal from Water: A Review

Abstract: Water is the most critical component of the earth's ecosystem because it is fundamental to the survival of plants and animals. However, our water supply is continuously polluting. Removing contaminants from water is a crucial part of addressing water scarcity and maintaining a healthy ecosystem for all. This review focuses on adsorption and the CNTs/AC family nano adsorbents and their contribution to the removal of fluoride and other contaminants. Many types of wastewater treatment methods have been employed, including precipitation, ion-exchange, adsorption, membrane filtration, etc. A water technology with great efficiency and low cost, without requiring costly infrastructure, is the most preferred option due to adsorption. Recently, the application of carbon family nanomaterials as adsorbents has been prevalent due to their phenomenal surface properties, simple customization, immense specific surface area, numerous variations in structural type, chemical stability, porosity, low density, ease of regeneration, and the ability to be reused. Hazardous contaminants, such as fluoride, generate major public health risks. Water contamination by heavy metals provides a significant health concern, including an increased chance of getting diseases like cancer, anaemia, carcinogenic effects, and acute effects in children. The increased presence of fluoride in water could cause fluorosis, joint pain, severe anaemia, and other problems. The following review focuses on current findings regarding the utilisation of CNTs and AC nanoparticles in the elimination of harmful contaminants and fluoride.

Impact of Hydroxyurea on Clinical and Biological Parameters of Sickle Cell Anemia in Children in Abidjan.

Background: The lives of individuals affected by sickle cell disease are marked by painful crises sometimes accompanied by complications. Curative treatments such as bone marrow transplantation or gene therapy exist, but are not currently performed in Côte d'Ivoire. Treatment with hydroxyurea remains an effective alternative. The aim of our study is to contribute to improving the management of children with sickle cell disease.&#x0D; Methods: We conducted a prospective observational study from November 2017 to April 2019 at the at the Yopougon University Hospital. Children aged 5 to 15 years experiencing at least 3 vaso-occlusive crises (VOC) per year were included in the study after obtaining informed and written consent from their parents. Each patient received a daily dose of 15mg/kg of hydroxyurea.&#x0D; Results: The mean age of the children was 9 years. More than 75% of patients were homozygous SSFA2 major sickle cell individuals. After 6 months on hydroxyurea, our study observed rates of 84.4%, 100%, and 97.8%, respectively, for the absence of vaso-occlusive crises, hospitalization, and transfusion. Biologically, from M0 to M12 the mean hemoglobin level increased significantly, from 7.24 to 8.55 g/dL; white blood cell (WBC) and platelet counts decreased; Fetal hemoglobin (Hb F) increased significantly from 10.3% to 19.7%. Biochemical parameters within normal ranges, except for a moderate treatment-related increase in transaminases.&#x0D; Conclusion: The induction of fetal hemoglobin (Hb F) production through hydroxyurea intake is the primary mechanism by which hydroxyurea modifies the pathogenesis of sickle cell disease

Clinical Signs and Treatment of New-Onset Bone Marrow Failure Associated SARS-CoV-2 Infection in Children: A Single Institution Prospective Cohort Study.

Viral infections can cause direct and indirect damage to hematopoietic stem cells. The objectives of this study were to identify the frequency and severity of aplastic anemia in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as recognize the response to treatment. 13 children with newly diagnosed severe aplastic anemia were enrolled in this prospective clinical trial. Blood samples were obtained from all patients to detect SARS-CoV-2 antibodies, and nasopharyngeal swabs were collected for reverse-transcription Polymerase Chain Reaction to detect SARS-CoV-2 viruses. According to the laboratory results, patients were classified as having SARS-CoV-2 positive antibodies and SARS-CoV-2 negative antibodies. Both groups received combined cyclosporine (CsA) + Eltrombopag (E-PAG). The hematological response, either complete response (CR) or partial response (PR), no response (NR), and overall response (OR) rates of combined E-PAG + CsA treatment after 6 months were evaluated. Four children were recognized to have aplastic anemia and SARS-CoV-2 positive antibodies. Two patients fulfilled the hematological criteria for CR and no longer required transfusion of packed red blood cells (PRBCs) or platelets, and one had PR and was still PRBC transfusion-dependent but no longer required platelet transfusion. The remaining patient showed NR, and he had died before reaching the top of the HSCT waiting list. Moreover, six patients in the SARS-CoV-2 negative antibodies group had CR, while three patients had PR. The difference in ANC, Hg, and platelet counts between both groups was not significant. The SARS-CoV-2 virus is added to several viral infections known to be implicated in the pathogenesis of aplastic anemia. Studies are needed to establish a definitive association and determine whether the response of bone marrow failure to standard therapy differs from that of idiopathic cases.

Intestinal microbiota composition and efficacy of iron supplementation in Peruvian children.

Despite repeated public health interventions, anemia prevalence among children remains a concern. We use an evolutionary medicine perspective to examine the intestinal microbiome as a pathway underlying the efficacy of iron-sulfate treatment. This study explores whether gut microbiota composition differs between anemic children who respond and do not respond to treatment at baseline and posttreatment and if specific microbiota taxa remain associated with response to iron supplementation after controlling for relevant inflammatory and pathogenic variables. Data come from 49 pre-school-aged anemic children living in San Juan de Lurigancho, Lima, Peru. We tested for differences in alpha and beta diversity using QIIME 2 and performed differential abundance testing in DESeq2 in R. We ran multivariate regression models to assess associations between abundance of specific taxa and response while controlling for relevant variables in Stata 17. While we found no evidence for gut microbiota diversity associated with child response to iron treatment, we observed several differential abundance patterns between responders and non-responders at both timepoints. Additionally, we present support for a nonzero relationship between lower relative abundance of Barnesiellaceae and response to iron supplementation in samples collected before and after treatment. While larger studies and more specific approaches are needed to understand the relationship between microbes and anemia in an epidemiological context, this study suggests that investigating nutritional status and pathogen exposure is key to better understanding the gut microbiome and impact of iron fortification.

Early Childhood Caries Prevalence &amp; Associated Factors In A Low Income Urban Community Of Karachi

Objectives: The primary and secondary objective of the study was to determine the prevalence of Early Childhood Caries among 2-6 year old children living in a low income, urban community of Karachi and to describe oral health and hygiene in the study population showing association be- tween Early Childhood Caries and anemia in 2-6 year old children, which was also the aim of our study. Methods: A cross-sectional, community-based survey was conducted on a total of 409 children in Sultanabad between 2 and 6 years of age, Karachi. A preformed, structured questionnaire collected information on child related, parental, and household characteristics. Included participants were one child, either male or female, aged between 2 years and 6 years at the time of the survey and the fam- ily was a permanent resident of Sultanabad, who had been living in the same vicinity for at least the last 6 months. Exclusion criteria were children with dento-facial or skeletal deformities such as cleft lip/palate or any congenital dysplasia. Statistical procedures and analyses including descriptive analy- sis, uni-variate and multivariable modeling were all performed on STATA version 12. Results: A total of 409 households from 6 blocks were surveyed from the community. The overall prevalence of Early Childhood Caries was 52.5% (95% CI: 47.7%-57.3%), which included 29.3% (25.0%-33.6%) mild/moderate Early Childhood Caries and 23.2% (19.2%-27.2%) severe Early Child- hood Caries. Frequency was higher in older age groups and in male children. The zero-inflated nega- tive binomial regression model identified the child’s anaemic status to be associated with DMFT scores; we found significant association between mean DMFT scores and the presence of severe anaemia in children. Conclusion: The study concluded that high burden of Early Childhood Caries in the community, most of which comprises decayed, untreated teeth. The findings add to the current evidence showing asso- ciation between Early Childhood Caries and anaemia in 2-6 year old children.

Is child anemia associated with early childhood development? A cross-sectional analysis of nine Demographic and Health Surveys.

Anemia is a significant public health problem in many low- and middle-income countries (LMICs), with young children being especially vulnerable. Iron deficiency is a leading cause of anemia and prior studies have shown associations between low iron status/iron deficiency anemia and poor child development outcomes. In LMICs, 43% of children under the age of five years are at risk of not meeting their developmental potential. However, few studies have examined associations between anemia status and early childhood development (ECD) in large population-based surveys. We examined the associations between severe or moderate anemia and ECD domains (literacy-numeracy, physical, social-emotional, and learning) and an overall ECD index among children age 36-59 months. Nine Demographic and Health Surveys (DHS) from phase VII of The DHS Program (DHS-7) that included the ECD module and hemoglobin testing in children under age five years were used. Bivariate and multivariate logistic regressions were run for each of the five outcomes. Multivariate models controlled for early learning/interaction variables, child, maternal, and paternal characteristics, and socio-economic and household characteristics. Results showed almost no significant associations between anemia and ECD domains or the overall ECD index except for social-emotional development in Benin (AOR = 1.00 p < 0.05) and physical development in Maldives (AORs = 0.97 p < 0.05). Attendance at an early childhood education program was also significantly associated with the outcomes in many of the countries. Our findings reinforce the importance of the Nurturing Care Framework which describes a multi-sectoral approach to promote ECD in LMICs.