Evaluation of iron-deficiency anemia by an iron supplementation trial in children living at a 2,800-m altitude.

Hemoglobin, hematocrit, serum iron and total iron-binding capacity were measured in 38 apparently healthy children living in Quito (2:800 meters in altitude). One child was considered anemic according to the WHO reference adjusted to altitude (hemoglobin less than 12.3 g/dl) and 10 had transferrin saturation of less than 15%. Thirty children received orally 2 mg/kg per day of elemental iron for 3 mth. A significant increase in hemoglobin level, serum iron-concentration, and transferrin saturation, and a significant decrease in total iron-binding capacity were observed. Nine children increased their hemoglobin concentration by greater than 1 g/100 ml and could be considered as true anemics. At the end of the supplementation, only one child had a transferrin saturation coefficient of less than 15%. WHO references for hemoglobin adjusted to altitude seem to underestimate the prevalence of anemia for populations living at high altitudes.