Wang Jie, Wang Hui, Chang Suying, Zhao Liyun, Fu Ping, Yu Wentao, Man Qingqing, Scherpbier Robert, Pan Lili, Duan Yifan, Yin Shi-An
Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Department of Population Research, China Population and Development Research Center, Beijing, China.
PLoS One. 2015 Oct 21;10(10):e0140840. doi: 10.1371/journal.pone.0140840. eCollection 2015.
Malnutrition and anemia affect large numbers of young children living in poor areas of China. Multi-micronutrient deficiencies may be related to the prevalence of anemia in different populations, and identifying the risk factors that render children susceptible to anemia is the first step in combating anemia effectively.
In this cross-sectional study, a total of 1370 children under 3 years old were selected based on probability proportional to size sampling principles from poor counties of China. Basic characteristics data were collected by questionnaire; then anthropometrics and hemoglobin were measured in the field and anemia prevalence evaluated. Venous blood was drawn from children aged 12-35 months (N = 553) to evaluate micronutrient status. Logistic regression was used to identify the risk factors for children's anemia.
Among children aged 0-35 months, the prevalence of stunting, low body weight and wasting was 17.5%, 8.6% and 5.1%, respectively, and 25.6% of the children were affected by anemia, with more anemic infants and younger children than older children (P <0.01). There were 26.5%, 12.8%, 14.1% and 20.0% of the children aged 12-35 months affected by iron deficiency, vitamin D deficiency, folic acid deficiency and vitamin B12 deficiency, respectively. For children aged 0-11 months who were breastfed, the mothers' anemic status was the only factor associated with the child's anemia (OR = 2.6; 95% CI: 1.2-5.4, P < 0.05). For children aged 12-35 months, multivariate logistic regression indicated that anemia was significantly associated with iron and vitamin B12 deficiency (OR = 5.3; 95% CI: 1.9-14.5, P < 0.01) and monotonous diet (OR = 2.3; 95% CI: 1.1-4.7, P < 0.05) after adjusting for age and gender.
The prevalence of anemia was higher in children under 2 years old and requires urgent intervention. An effective intervention strategy should include iron and vitamin B12 supplements, improving dietary diversity and controlling breastfeeding mothers' anemia.
营养不良和贫血影响着中国贫困地区的大量幼儿。多种微量营养素缺乏可能与不同人群的贫血患病率有关，识别使儿童易患贫血的危险因素是有效防治贫血的第一步。
在这项横断面研究中，根据规模概率抽样原则，从中国贫困县选取了1370名3岁以下儿童。通过问卷调查收集基本特征数据；然后在现场测量人体测量指标和血红蛋白，并评估贫血患病率。采集12 - 35个月龄儿童（N = 553）的静脉血以评估微量营养素状况。采用逻辑回归分析确定儿童贫血的危险因素。
在0 - 35个月龄儿童中，生长迟缓、低体重和消瘦的患病率分别为17.5%、8.6%和5.1%，25.6%的儿童患有贫血，贫血婴儿和年幼儿童多于年长儿童（P <0.01）。12 - 35个月龄儿童中，缺铁、维生素D缺乏、叶酸缺乏和维生素B12缺乏的患病率分别为26.5%、12.8%、14.1%和20.0%。对于0 - 11个月龄母乳喂养的儿童，母亲的贫血状况是与儿童贫血相关的唯一因素（OR = 2.6；95%CI：1.2 - 5.4，P <0.05）。对于12 - 35个月龄儿童，多因素逻辑回归分析表明，在调整年龄和性别后，贫血与铁和维生素B12缺乏（OR = 5.3；95%CI：1.9 - 14.5，P <0.01）以及饮食单调（OR = 2.3；95%CI：1.1 - 4.7，P <0.05）显著相关。
2岁以下儿童贫血患病率较高，需要紧急干预。有效的干预策略应包括补充铁和维生素B12、改善饮食多样性以及控制母乳喂养母亲的贫血。
