Malaria, hookworms and recent fever are related to anemia and iron status indicators in 0- to 5-y old Zanzibari children and these relationships change with age

Rebecca J. Stoltzfus, Hababu M. Chwaya, Antonio Montresor, Marco Albonico, Lorenzo Savioli, James M. Tielsch

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

In Zanzibar and other tropical regions, iron deficiency, malaria and multiple helminth infections coexist. We addressed the following questions: 1) What are the predictors of low hemoglobin in Zanzibari preschool children? 2) Are indicators of iron status informative in this population? 3) Does malaria modify the relation of iron indicators to hemoglobin? We used multivariate regression to analyze cross-sectional data from a community- based sample of rural Zanzibari children who were not ill (n = 490; 4-71 mo of age) in whom we assessed hemoglobin, serum ferritin (SF), erythrocyte protoporphyrin (EP), serum transferrin receptor (TfR), recent fever, malaria parasitemia and helminth fecal egg counts. Of hemoglobin values, 80% were <100 g/L and 15.5% were <70 g/L. In children <18 mo of age, 40.2% of hemoglobin values were <70 g/L. Our primary findings were as follows: 1) In children <30 mo old, hemoglobin was associated with malaria but not hookworms, whereas in children ≥30 mo, hemoglobin was related to hookworms but not malaria. In the younger age group, male sex and recent fever also predicted lower hemoglobin. 2) The three iron indicators were informative in this population but did not reflect only iron status. Malaria elevated SF in younger children and TfR and EP in both age groups. Fever elevated SF in older children and EP in both age groups, but not TfR. 3) Malaria modified the relation of all three indicators to hemoglobin. The relation of SF to hemoglobin was weak overall, and absent in malaria-infected children. EP and TfR were strongly related to hemoglobin, but this relation was attenuated by malaria.

Original languageEnglish (US)
Pages (from-to)1724-1733
Number of pages10
JournalJournal of Nutrition
Volume130
Issue number7
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Anemia
  • Children
  • Helminth infection
  • Iron
  • Malaria
  • Nutrition assessment

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Fingerprint

Dive into the research topics of 'Malaria, hookworms and recent fever are related to anemia and iron status indicators in 0- to 5-y old Zanzibari children and these relationships change with age'. Together they form a unique fingerprint.

Cite this