Non-anemic Children Research Articles

The correlation between anemia and intelligence quotient (IQ) in children: a systematic review and meta-analysis

Introduction: Anemia is considered as an important health problem because it severely affects children's growth and development. It impairs the immune mechanisms and is also associated with increased morbidity. This meta-analysis aims to assess the correlation between anemia and intelligence quotient (IQ) in children. Methods: Articles on anemia and IQ in children under 18 years old were searched in Scopus, Pubmed, and ScienceDirect, using the search term “(((Anemia) OR (Hemoglobin)) AND ((Intelligence Quotient) OR (IQ)))”. Articles before 2000 and published in languages other than English were excluded. The outcome is Intelligence Quotient. Two independent reviewers performed article screening. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The statistical analysis was conducted using Review Manager 5.4. Results: A total of 7 published studies with a total number of 1339 subjects were included in this meta-analysis. The pooled analysis showed there was a statistically significant decrease in mean IQ in anemic children, compared to non-anemic children (-9.97, 95% CI: -17.99 to -1.96, p = 0.01, I2 = 99%). All of the studies have a low risk of bias. Conclusion: A decrease in mean IQ in children under 18 years old is associated with the presence of anemia.

Iron deficiency anemia in relation to pinch strength and hand dexterity in preschool children: a cross-sectional study

BackgroundIron deficiency anemia (IDA) constitutes a considerable nutritional problem in Egyptian preschool children. Moreover, IDA limits physical activity performance and interferes with children's development. Accordingly, we aim to investigate the correlation between IDA and hand dexterity and pinch grip strength in preschool children.ResultsThis observational cross-sectional study encompassed the participation of 87 children, comprising both genders, with an age range of 5–6 years. The cohort was initially stratified into three distinct groups: Group A comprised 36 non-anemic children, group B included 25 children with mild iron-deficiency anemia (IDA), and group C consisted of 26 children with moderate IDA. After group delineation, comprehensive laboratory analyses were performed on all participants to assess for IDA, involving a thorough examination of their complete blood picture, hemoglobin (Hb) levels, serum iron levels, and serum ferritin levels. The evaluative metrics employed in this study encompassed the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and the Baseline Mechanical Pinch Gauge. These instruments were utilized to assess manual dexterity and pinch strength, specifically tip-to-tip and tripod strength. This investigation revealed a positive correlation between Hb, serum iron, and serum ferritin levels with both manual dexterity and pinch strength across all three groups.ConclusionThis study highlights that IDA negatively affects hand dexterity and pinch grip strength in preschool children. Managing IDA early is crucial for improving their physical performance and overall development.

Effect of Blastocystis sp. infection on hematological parameters and trace element status in children with iron-deficiency anemia.

Iron deficiency anemia (IDA), which causes greater morbidity and mortality in children, has multifactorial causes, including many helminthic and protozoal infections. Herein, the study aimed to find out the frequency and associated risk of Blastocystis sp. infection among children with IDA, together with the estimation of the serum levels of iron, zinc, copper, and vitamin A. Both stool and blood samples were obtained from 90 children with a confirmed diagnosis of IDA and 90 non-anemic children. Blastocystis sp. was diagnosed by direct stool examination and Invitro cultivation methods. Different hematological parameters were recorded, and the serum level of iron, zinc, copper, and vitamin A was measured in serum samples. The overall predominance of Blastocystis in children was 36.7%, significantly higher (P < 0.001) in children with IDA (55.6%) compared to non-anemic controls (17.8%). Furthermore, Blastocystis infected children were 5.781 times more prone to be anemic (OR = 5.781). All IDA cases with positive Blastocystis infection had a mean hemoglobin level of 9.55 g/dl (moderate anemia). While in other non-infected IDA cases, it was 9.56 g/dl, showing no statistical difference (P = 0.845). Serum levels of zinc, iron, and vitamin A considerably decreased, whereas serum copper levels significantly increased in IDA children infected with Blastocystis. The current research is the first in Egypt to indicate that Blastocystis infection in children is a high-risk factor for developing IDA. Blastocystis infection significantly alters the metabolic and biochemical processes and interferes with the absorption of micronutrients and vitamin A in IDA children.

LRG1 Associates with Iron Deficiency Anemia Markers in Adolescents.

Leucine-rich α-2 glycoprotein1 (LRG1) has been shown to be associated with several health conditions; however, its association with iron deficiency anemia, especially in children, has not been previously explored. In this study, we investigated the association between LRG1 and several iron deficiency anemia markers, including hemoglobin (Hb), albumin, red cell distribution width (RDW), iron, ferritin, and Hb transferrin saturation. A total of 431 participants were included in this analysis aged between 11 and 14 years. Higher LRG1 levels were observed in children diagnosed with anemia [31.1 (24.6, 43.2) µg/mL] compared to non-anemic children [29.2 (22.7-35.95) µg/mL]. Statistically significant differences of LRG1 level across the three groups (tertiles) of Hb, iron, transferrin saturation, albumin, RDW, ferritin, and WBC were observed. Strong negative correlations were observed between LRG1 and Hb (Spearman's rho = -0.11, p = 0.021), albumin (Spearman's rho = -0.24, p < 0.001), iron (Spearman's rho = -0.25, p < 0.001), and Hb transferrin saturation (Spearman's rho = -0.24, p < 0.001), whereas circulating LRG1 levels were positively associated with RDW (Spearman's rho = 0.21, p < 0.001). In conclusion, our findings demonstrate for the first time the strong association between iron deficiency anemia markers and LRG1 in otherwise healthy school-aged children. However, further studies are needed to corroborate those results and to look for similar associations in other population subgroups.

Associations of HIV and iron status with gut microbiota composition, gut inflammation and gut integrity in South African school-age children: a two-way factorial case-control study.

Human immunodeficiency virus (HIV) and iron deficiency (ID) affect many African children. Both HIV and iron status interact with gut microbiota composition and related biomarkers. The study's aim was to determine the associations of HIV and iron status with gut microbiota composition, gut inflammation and gut integrity in South African school-age children. In this two-way factorial case-control study, 8- to 13-year-old children were enrolled into four groups based on their HIV and iron status: (1) With HIV (HIV+) and ID (n = 43), (2) HIV+ and iron-sufficient nonanaemic (n = 41), (3) without HIV (HIV-) and ID (n = 44) and (4) HIV- and iron-sufficient nonanaemic (n = 38). HIV+ children were virally suppressed (<50 HIV RNA copies/ml) on antiretroviral therapy (ART). Microbial composition of faecal samples (16S rRNA sequencing) and markers of gut inflammation (faecal calprotectin) and gut integrity (plasma intestinal fatty acid-binding protein [I-FABP]) were assessed. Faecal calprotectin was higher in ID versus iron-sufficient nonanaemic children (p = 0.007). I-FABP did not significantly differ by HIV or iron status. ART-treated HIV (redundancy analysis [RDA] R2 = 0.009, p = 0.029) and age (RDA R2 = 0.013 p = 0.004) explained the variance in the gut microbiota across the four groups. Probabilistic models showed that the relative abundance of the butyrate-producing genera Anaerostipes and Anaerotruncus was lower in ID versus iron-sufficient children. Fusicatenibacter was lower in HIV+ and in ID children versus their respective counterparts. The prevalence of the inflammation-associated genus Megamonas was 42% higher in children with both HIV and ID versus HIV- and iron-sufficient nonanaemic counterparts. In our sample of 8- to 13-year-old virally suppressed HIV+ and HIV- children with or without ID, ID was associated with increased gut inflammation and changes in the relative abundance of specific microbiota. Moreover, in HIV+ children, ID had a cumulative effect that further shifted the gut microbiota to an unfavourable composition.

Perbedaan Manifestasi Klinis Kejang Demam Pada Anak Anemia dengan Tanpa Anemia di RSPAL dr. Ramelan Surabaya Tahun 2019-2022

Study aims: Febrile seizures are the most common neurological disorder in children. The incidence of febrile seizures is related to the incidence of epilepsy at 2-4% in the future and the probability of recurrence is about 30% and 50% after the first and second febrile seizures, respectively. Several recent studies have suggested that febrile seizures are more common in children with anemia. Anemia patients who experience febrile seizures can cause more severe clinical manifestations. Where 40.5% of the incidence of anemia in Indonesia occurs in children under the age of 5 years. Therefore, this study is conducted to determine the differences of the clinical manifestations of febrile seizures with and without anemia in children at RSPAL Dr. Ramelan Surabaya on 2019-2022.&#x0D; Methods: This study was an observational analytic study with a cross-sectional study approach and qualitative methods from secondary medical record data of infants and children aged 6 months-5 years at RSPAL Dr. Ramelan Surabaya for the period May 2019-May 2022. The number of samples in this study was 82 samples.&#x0D; Results: The characteristics of the sample which experiences the most febrile seizures occurres between the ages of 6-18 months, the gender of male with a temperature &gt;38°C and manifestations in the form of simple febrile seizures. In addition, the results of the fisher exact test with a significance level of 5% shows p = 0.96 which means there is no difference in the clinical manifestations of febrile seizures in anemic and non-anemic children.&#x0D; Conclusion: The conclusion of this study is that based on the classification of febrile seizures, the most common clinical manifestations that occur in children with anemia and without anemia are simple febrile seizures. So that there is no difference in the clinical manifestations of febrile seizures in anemic children and without anemia.

Latent iron deficiency in non-anemic children under five years of age

Latent iron deficiency in non-anemic children under five years of age

Frequency of Anemia in Hospitalized Children Ages 0-12 Years and Associated Factors: A Cross-Sectional Study

Background: Anemia affects the psychological and physiologic well-being of children worldwide. In Pakistan, anemia among children and its associated factors is scarcely studied and the available knowledge is not up-to date. This study aims to better understand the anemic burden among pediatric population in our country. Methods: Cross-sectional study of 1 month was conducted from January to February 2020 comprising 299 children who were hospitalized in a tertiary care hospital with ages from 1 month to 12 years, located in Lahore. Analysis of different demographic data, breast feeding duration, age, nutritional status, gender, iron supplementation, solid food introduction, disease of diagnosis and other background parameters in association with hemoglobin level is done in this article. We performed chi-square analysis and logistic regression to assess anemia with related factors. Results: Overall percentage of non-anemic and anemic children were 56.9% and 43.1% respectively among whom male children were 62.4% and female were 37.6% anemic. Among anemic patients, 26.7% and 45.5% of children who were admitted suffered from mild and moderate anemia, respectively. The most affected age group was 6-59-month-old. There was a 9 times higher risk of anemia among well-nourished children as compared to over nourished children. Conclusion: The group mostly affected by anemia is of age between 6 to 59 months. To combat this crisis, certain measures are required as exclusive breast feeding for 6 months, weaning at age of 6 months and iron supplementation if iron requirements are not fulfilled by diet for children.

Trends in ferritin measurements in children and adolescents: AFinnish 9-year observational study.

AimA lack of stored iron, indicated by low serum ferritin, has been associated with various clinical symptoms. There are no longitudinal data on the frequency of ferritin measurements in children and adolescents.MethodsA total of 2834 children aged <18 years with serum ferritin and other anaemia‐related blood parameters taken during an outpatient visit between 2012 and 2019 were investigated. Patients with acute infections were excluded. Nationwide temporal and regional variations and correlations with public information searches through Google were analysed.ResultsA significant increase in the frequency of ferritin measurements was seen starting in 2018, with a 47‐fold rise in 2019 compared to 2012. A simultaneous escalation in Google Search activity was seen. Deficiency of stored iron was relatively common: 21.6% of children with normal haemoglobin and 14.9% of non‐anaemic children with normal red cell indices exhibited ferritin levels below 15 μg/L.ConclusionFerritin measurement has increased greatly among children and adolescents. Our results suggest that public interest and popular trends can significantly influence health care practices. This calls for further investigation into the causes and consequences of such a phenomenon. Prospective randomised intervention studies are needed to evaluate the utility of iron supplementation in patients with low iron storage levels.

Evaluation of Kidney Function Parameters in Children with Vitamin B12 Deficiency

Objective: Vitamin B12 is crucial for cell metabolism, deoxyribonucleic acid synthesis and cell proliferation. Hematological and neurological systems are known to be affected in vitamin B12 deficiency. The aim of this study was to research the effects of vitamin B12 deficiency on kidney function parameters. Material and Methods: Thirty-four children with vitamin B12 deficiency and 36 sex and age-matched healthy controls were included in the study. Complete blood count, serum urea, creatinin, vitamin B12, holotranscobalamin, methyl malonic acid, homocysteine, ferritin, folate and estimated glomerular filtration rate were recorded. Additionally, spot urine protein, microalbumin and neutrophil gelatinase-associated lipocalin were measured. Results: Kidney function parameters were normal for childrens that participated the study. Serum kidney function parameters adjusted for age also showed no significant difference between the two groups. No correlation was found between serum vitamin B12 and neutrophil gelatinase-associated lipocalin; however, a negative correlation was detected between neutrophil gelatinase-associated lipocalin and holotranscobalamin (r =-0.24, p =0.045). Holotranscobalamin was substantially lower in the group with vitamin B12 deficiency (p<0.001). Conclusion: No negative influence of B12 deficiency on kidney function was found in non-anemic children.

An Assessment of the Relationship of SNAP and Anemia Among School-Aged Children and Adolescents Living in Households With Food Insecurity.

Children in food-insecure households have an increased risk of anemia. Participation in Supplemental Nutrition Assistance Programs (SNAP) has several benefits. However, it is unknown if it ameliorates anemia among school-aged children and adolescents living in food-insecure households. This study aims to assess the association of SNAP participation and anemia among children and adolescents living in households experiencing food insecurity. The sample population (n = 1635), aged 6 to 18 years, were pooled from the 2003–2014 National Health and Nutrition Examination Survey (NHANES). The exposure of interest was self-reported household SNAP participation. The outcome variable was the presence or absence of anemia, classified using the blood hematocrit concentration values. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% Confidence Interval (CI) of the association between participation in SNAP and anemia in food-insecure children. We found that over 80% of anemic children and adolescents, living in food-insecure households, participated in SNAP, while 63% of non-anemic children and adolescents, living in food-insecure households participated in SNAP (p = .007). Among children living in food-insecure households, SNAP participants had 3-fold increased odds of anemia compared to those who do not participate in SNAP, after adjusting for confounders (OR = 3.33, 95% CI: 1.25–8.88). In this study, SNAP participation was associated with increased odds of anemia in children and adolescents living in food-insecure households. Additional research is needed to assess if these unexpected findings are related to the adequacy of SNAP, affordability, and accessibility to healthy foods, or the household and individual food preferences in food-insecure households.

Iron deficiency in preschool non-anemic Egyptian children

BackgroundIron deficiency anemia remains a common cause of anemia in young children. The term iron deficiency without anemia, or the so-called latent iron deficiency, has become increasingly significant as it is not only difficult to identify this condition in non-anemic children, but it also adversely affects neurocognitive development, and unfortunately, some of these effects may be irreversible and not respond to treatment. This cross-sectional study was conducted to evaluate iron status in 68 apparently healthy, non-anemic Egyptian children aged 1–6 years. They were subjected to detailed history-taking, physical examination, complete blood count, and tests for serum iron, total iron binding capacity, serum ferritin, and transferrin saturation.ResultsLow serum ferritin level and low transferrin saturation were detected in 41.2% and 47% of the children, respectively. Iron deficiency parameters were significantly affected among toddlers aged “1” to “3” years compared with preschool children, and boys were found to be more affected than girls of the same age group.ConclusionsA normal hemoglobin level does not exclude iron deficiency, which should be screened in healthy children to prevent the possible long-term effects of iron deficiency on their cognition and mental development.

Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial.

Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.

Iron status predicts cognitive test performance of primary school children from Kumasi, Ghana.

BackgroundGood nutritional status of school-aged children is crucial in achieving improved cognition. The objective of this study was to assess the relationship between nutritional status and cognition of school-aged children in the Kumasi metropolis, Ghana.Methods389 children were selected from ten government-owned schools. Socio-demographic and anthropometric data were collected. Blood samples were collected and analyzed for nutrients levels. Dietary intakes were assessed using food frequency questionnaire and previous day’s nutrients intake. Cognition test was performed using the Ravens Colored Progressive Matrix (RCPM).ResultsMean age of participants was 8.9±1.4 years, mean RCPM score was 17.9±5.4. More girls scored RCPM below the 40th percentile (45.5%) than boys (33.7%), while mother’s level of education significantly associated with RCPM percentiles of the children (p = 0.037). Four dietary patterns were generated from food frequency data, and scores of the second pattern, depicting vegetables, non-fruits, bread and cereals, showed a weak negative correlation (r = -0.132, p = 0.026) with previous day’s dietary zinc intake. Cognitive status did not vary by anthropometric and dietary patterns. More anemic (54.4%) than non-anemic (33.3%) children were below the 40th RCPM percentile. Mean previous day’s intake for folate (p<0.001), vitamin B6 (p = 0.018), iron (p<0.001), and zinc (p = 0.001) differed significantly between the cognitive test score percentiles of the children. Spearman rank correlation showed weak positive associations between RCPM score and hemoglobin (r = 0.246, p = 0.003) and serum ferritin (r = 0.176, p = 0.036). Binary regression analysis showed anemic children (aOR = 0.4; 95%CI = 0.2–0.8, p = 0.014), compared with non-anemic had decreased odds, while boys, compared with girls had increased odds (aOR = 2.0 95%CI = 1.0–4.0, p = 0.035) for scoring above the 50th RCPM percentile.ConclusionsIron status, especially hemoglobin levels, correlated with the cognitive performance of school-aged children in the metropolis. Thus nutritional strategies aimed at reducing iron deficiency anemia are needed.

Serum neutrophil gelatinase-associated lipocalin for predicting anemia of inflammation in children with urinary tract infection.

Anemia of inflammation (IA), the second most common cause of childhood anemia, results from macrophage iron sequestration and impaired erythropoiesis. Neutrophil gelatinase-associated lipocalin (NGAL) plays an important role in innate microbial immunity through its influence on intracellular iron homeostasis and inhibition of erythropoiesis. The predictive value of NGAL in IA was assessed in 74 children (age 6.30 ±3.64 months) with the first episode of urinary tract infection (UTI). Anemia of inflammation was found in 50% of children, including those with non-febrile UTI, and delayed onset of anemia was observed in 20% of children. There were no differences in NGAL levels between the anemic and non-anemic children, and no correlations between NGAL and hemoglobin (HGB) levels and red blood cell (RBC) count. In multivariate logistic regression analysis elevated C-reactive protein (CRP) was only independently associated with the presence of anemia in children with UTI [OR (95% CI): 1.128 (1.005-1.265), p = 0.040]. In stepwise multiple analysis age independently correlated with RBC (β = 0.051, p = 0.001), while CRP independently correlated with HGB (β = –0.037, p = 0.027) and RBC (β = –0.022, p = 0.014). ROC analysis demonstrated better diagnostic profiles for CRP, procalcitonin (PCT) and fever duration for predicting the risk of IA than NGAL (AUC: 0.690, 0.669, 0.678 vs. 0.638, respectively). Despite the increase in HGB levels after 4-5 weeks from the onset of UTI, HGB values were still significantly lower in the anemic than in non-anemic children. NGAL was not useful for predicting IA in UTI, since its diagnostic value was inferior to conventional inflammatory markers.

Prevalence of Helicobacter pylori Infection among Anemic School-Age Children in Egypt: A Cross-Sectional Population-Based Study

AbstractAnemia and Helicobacter pylori infection in school-age children are important public health problems. The association between H. pylori infection and the development of anemia, especially iron deficiency anemia, has been previously studied and until now it is still a matter of argument. This study aimed to determine the prevalence of anemia and H. pylori infection among school-age children and to find the association between H. pylori infection and anemia in school-age children. We conducted this population-based cross-sectional study in six Egyptian primary schools over a 12-month-period, including 1,200 students from all grades who fulfilled the inclusion criteria. The study participants were subjected to the following: medical history, clinical examination, and laboratory investigations included complete blood count and H. pylori antigen in stool, and according to the level of hemoglobin (Hb), we divided the students into two groups; the anemic group with Hb level &lt;11.5 g/dL and nonanemic group with Hb level ≥11.5 g/dL, and the serum ferritin levels were measured only for the anemic group as the best indicator for iron status. The overall prevalence of H. pylori infection was 25%. The overall prevalence of anemia was 13.25%, of which hypochromic microcytic anemia represented 87.4% of the anemic group, and the mean ferritin level in the anemic group was 18.56 ± 9.96 ng/mL. The prevalence of anemia among H. pylori-infected patients (62.3%) was significantly (p &lt; 0.001) higher than in noninfected children (37.7%). In the anemic group, the mean ferritin level in H. pylori-infected children was significantly lower than the mean level in the noninfected children (p &lt;0.001). Furthermore, the anemic group had a significantly higher incidence of H. pylori infection and a lower age (p &lt;0.001) in comparison with the nonanemic group. The dominant type of anemia in H. pylori-infected children was the microcytic hypochromic anemia, with a significantly higher incidence in comparison to other types of anemia (p &lt;0.001). The findings of this study demonstrate a significant association between H. pylori infection and anemia in school-aged children, especially iron deficiency anemia, as the incidence of H. pylori infection was greater in anemic children than in non-anemic children.

Language Disorders in Children with Iron Deficiency Anemia

Introduction: Children suffering from Iron Deficiency Anemia (IDA) have shown iron-deficiency associated with psychomotor and cognitive abnormalities and impact language and learning acquisition in children. Children of two years old also demonstrate a decrease in mental investment than non-anemic children, although there is an evident improvement once treatment started. This work aims to establish baseline data about the size and distribution of language disorders among kids with iron deficiency anemia.Method: This study carried out two groups: The (study group) included 25 children diagnosed with IDA. Compared to another group (control group), had 25 not diagnosed with IDA. According to the language assessment protocol, all children were assessed: Parents interview and history, audiological evaluation, Psychometric evaluation, Arabic Preschool Language Scale-4 APLS-4 test, Mansoura Arabic Articulatory Test, Complete blood count (CBC), Serum iron and ferritin test.Results: A statistically significant difference between the study and the control group regarding the (receptive, expressive, and total) row scores. There was a positive fair significant correlation between the receptive and expressive language score and serum iron.Conclusion: There is evidence that children with Iron Deficiency Anemia show more deficient language development than normal children.

Artemisinin Activity in Red Blood Cells from Anemic Children.

Artemisinin combination therapies are the current frontline therapy for falciparum malaria. Artemisinin is activated by heme iron, and the consequent production of reactive oxygen species and carbon-centered radicals results in rapid parasite clearance. Red blood cells (RBCs) from anemic iron-deficient individuals have decreased levels of heme, and such deficiencies are highly prevalent among children and pregnant women in malaria-endemic countries. We, therefore, investigated the possibility that host anemia could impair artemisinin activity and alter the drug sensitivity of artemisinin-resistant strains of Plasmodium falciparum. We collected RBCs from anemic (n = 35) and nonanemic (n = 11) Gambian children between the ages of 2 and 24 months. Parasites grown in RBCs from both groups were assessed in vitro using the ring-stage survival assay with artemisinin-resistant and artemisinin-sensitive strains of P. falciparum. No differences were found in artemisinin sensitivity (P > 0.05), and there was no correlation between artemisinin activity and host hemoglobin levels. Standard antimalarial drug activity assays for representatives of the major classes of antimalarial drugs found no differences in the IC50 values against P. falciparum between anemic and nonanemic RBCs. We conclude that host anemia does not influence artemisinin activity.

The Prevalence and Risk Factors of Iron Deficiency Anemia in Thai Infants by Complete Blood Count at 9-Month-Old

Background: Infants are the most at risk from iron deficiency (ID) and iron deficiency anemia (IDA), but the prevalence of the latter in this group is unclear. Estimation as to the prevalence of IDA using Hb of less than 11 g/dL may have been exaggerated due to thalassemia and hemoglobinopathies. On the other hand, iron studies are costly and not routinely available in low resource settings. In the present research, the authors estimated the prevalence of IDA in 9-month-old infants at the authors’ well-baby clinic by improving the post-iron-treatment criteria of Hb and defined the risk factors of IDA in infants. Objective: To estimate the prevalence of IDA in 9-month-old infants at the well-baby clinic and to define the risk factors of IDA. Materials and Methods: A retrospective cohort study of 391 children who had complete blood count (CBC) screening at 9-month-old at the well-baby clinic. Anemia was defined according to the WHO criteria (hemoglobin of 11 g/dL or less for children aged six months to five years). IDA was defined as an increase of at least Hb 1 g/dL after receiving iron treatment for one to two months. Mean levels of hematological parameters were compared between groups using independent samples t-test. The characteristics with potential risk factors for IDA were compared with iron non-responder and normal group. Multivariable adjusted odd ratios and 95% confidence intervals (CIs) of IDA were calculated using multinomial logistic regression with control for risk factors. Results: One hundred fourteen children (29.1%) were anemic. There was no difference between anemic and non-anemic children in baseline characteristics. Seventy children in the anemic group were diagnosed with IDA. The prevalence of IDA in the present study was 17.9%. The IDA group showed significant improvement in Hb, Hct, MCV, MCH after receiving iron treatment, but there were no significant changes in the iron non-responder group. The risk factor for IDA was exclusive breastfeeding for at least six months (odds ratio 3.14, 95% CI 1.67 to 5.90, p&lt;0.001). Conclusion: The prevalence of IDA and anemia in the present study was 17.9% and 29.1%, respectively. The risk factor for IDA was exclusive breastfeeding for at least six months. Keywords: Anemia, Iron deficiency anemia, Prevalence of anemia in infants, Complete blood count screening, Thai infants

Iron Deficiency Anemia and Serum Hepcidin Level in Children with Typhoid Fever: A Case–Control Study

Abstract Objective Typhoid fever is a common systemic bacterial infection in children with a complex interplay between serum hepcidin and iron. We investigated the relationship between iron deficiency anemia (IDA) and serum hepcidin level in children with acute typhoid fever. Methods We conducted a preliminary case–control study in Mansoura University Children's Hospital, Egypt from April 2017 to May 2019 including 30 children aged 5 to 15 years with confirmed acute typhoid fever. We recruited 15 healthy nonanemic children, of comparable ages and sex as controls from the same hospital while attending for nonfebrile complaints. Typhoid fever cases were subdivided according to IDA existence into 16 cases with IDA and 14 non-IDA cases. We excluded all children having diseases which may affect serum iron and hepcidin levels, for example, liver, blood, gastrointestinal, and kidney diseases, and patients receiving drugs interfering with iron metabolism. All participants were subjected to complete blood count, serum ferritin, iron, hepcidin levels, and total iron-binding capacity (TIBC). Results In non-IDA typhoid fever group, serum iron level was significantly low, while serum hepcidin level was significantly high when compared with controls (p &lt; 0.001 and p = 0.02, respectively). In IDA typhoid fever group, no statistically significant difference existed as regards serum hepcidin level when compared with controls (p = 0.53). No significant correlations were detected between serum hepcidin levels and hemoglobin, serum iron, ferritin, and TIBC values in each group. Conclusion Preexisting iron status could affect serum hepcidin level in patients with acute typhoid fever. Coexistence of IDA might oppose the up-regulatory effect of acute typhoid fever on serum hepcidin level.