使用墨西哥社会保障机构提供的医疗服务的2岁以下儿童的贫血以及铁、叶酸和锌缺乏症的患病率
Prevalence of anemia and deficiency of iron, folic acid, and zinc in children younger than 2 years of age who use the health services provided by the Mexican Social Security Institute.
作者信息
Duque Ximena, Flores-Hernández Sergio, Flores-Huerta Samuel, Méndez-Ramírez Ignacio, Muñoz Sergio, Turnbull Bernardo, Martínez-Andrade Gloria, Ramos Rosa I, González-Unzaga Marco, Mendoza María E, Martínez Homero
机构信息
Unidad de Investigación en Epidemiología Nutricional, Instituto Mexicano del Seguro Social, Mexico DF, Mexico.
出版信息
BMC Public Health. 2007 Nov 30;7:345. doi: 10.1186/1471-2458-7-345.
BACKGROUND
In Mexico, as in other developing countries, micronutrient deficiencies are common in infants between 6 and 24 months of age and are an important public health problem. The objective of this study was to determine the prevalence of anemia and of iron, folic acid, and zinc deficiencies in Mexican children under 2 years of age who use the health care services provided by the Mexican Institute for Social Security (IMSS).
METHODS
A nationwide survey was conducted with a representative sample of children younger than 2 years of age, beneficiaries, and users of health care services provided by IMSS through its regular regimen (located in urban populations) and its Oportunidades program (services offered in rural areas). A subsample of 4,955 clinically healthy children was studied to determine their micronutrient status. A venous blood sample was drawn to determine hemoglobin, serum ferritin, percent of transferrin saturation, zinc, and folic acid. Descriptive statistics include point estimates and 95% confidence intervals for the sample and projections for the larger population from which the sample was drawn.
RESULTS
Twenty percent of children younger than 2 years of age had anemia, and 27.8% (rural) to 32.6% (urban) had iron deficiency; more than 50% of anemia was not associated with low ferritin concentrations. Iron stores were more depleted as age increased. Low serum zinc and folic acid deficiencies were 28% and 10%, respectively, in the urban areas, and 13% and 8%, respectively, in rural areas. The prevalence of simultaneous iron and zinc deficiencies was 9.2% and 2.7% in urban and rural areas. Children with anemia have higher percentages of folic acid deficiency than children with normal iron status.
CONCLUSION
Iron and zinc deficiencies constitute the principal micronutrient deficiencies in Mexican children younger than 2 years old who use the health care services provided by IMSS. Anemia not associated with low ferritin values was more prevalent than iron-deficiency anemia. The presence of micronutrient deficiencies at this early age calls for effective preventive public nutrition programs to address them.
背景
与其他发展中国家一样，在墨西哥，6至24个月大的婴儿中微量营养素缺乏情况普遍，这是一个重要的公共卫生问题。本研究的目的是确定使用墨西哥社会保障局（IMSS）提供的医疗服务的2岁以下墨西哥儿童中贫血以及铁、叶酸和锌缺乏的患病率。
方法
对2岁以下儿童、受益人和通过IMSS常规方案（位于城市人口中）及其机会均等计划（在农村地区提供的服务）使用其医疗服务的人员进行了全国性调查。对4955名临床健康儿童的子样本进行研究以确定其微量营养素状况。采集静脉血样以测定血红蛋白、血清铁蛋白、转铁蛋白饱和度百分比、锌和叶酸。描述性统计包括样本的点估计值和95%置信区间以及从中抽取样本的更大人群的预测值。
结果
2岁以下儿童中有20%患有贫血，27.8%（农村）至32.6%（城市）患有缺铁；超过50%的贫血与低铁蛋白浓度无关。铁储备随着年龄增长而更加耗尽。城市地区低血清锌和叶酸缺乏率分别为28%和10%，农村地区分别为13%和8%。城市和农村地区同时缺铁和缺锌的患病率分别为9.2%和2.7%。贫血儿童的叶酸缺乏百分比高于铁状态正常的儿童。
结论
铁和锌缺乏是使用IMSS提供的医疗服务的2岁以下墨西哥儿童中的主要微量营养素缺乏情况。与低铁蛋白值无关的贫血比缺铁性贫血更为普遍。在这个早期阶段存在微量营养素缺乏情况，需要有效的预防性公共营养计划来解决这些问题。
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