Work

Anemia and Micronutrient Deficiencies in Young Children in Urban Slums of Mumbai, India

Year: 2020

Type: article

Abstract: To examine the burden of anemia and micronutrient deficiencies among young children living in urban slums of Mumbai, India. Participants were children 10–18 months of age (n = 278) residing in urban slums in Mumbai who were screened as part of a randomized feeding trial of biofortified pearl millet. Venous blood was collected by a pediatric phlebotomist and hemoglobin (Hb) concentrations were assessed via Coulter counter. Samples were processed and stored <−80°C until laboratory analyses. Serum ferritin (SF), vitamin B12, and erythrocyte (RBC) folate concentrations were analyzed via chemiluminescence. C-reactive protein (CRP) was analyzed by nephelometry, α-1 acid glycoprotein (AGP) was analyzed by spectrophotometry, and serum retinol was evaluated via HP-LC. Serum ferritin and serum retinol levels were adjusted for inflammation using methods proposed by Thurman. Anemia and severe anemia were defined as Hb < 11.0 g/dL and Hb < 7.0 g/dL. Iron deficiency (ID) was defined as SF < 12.0 µg/L, iron insufficiency was defined as SF < 20.0 µg/L, and inflammation was defined as CRP > 5.0 mg/L. Iron deficiency anemia was defined as Hb < 11.0 g/dL and SF < 12.0 µg/L. Vitamin A deficiency was defined as serum retinol <20.0 µg/L. Vitamin B12 deficiency and vitamin B12 insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L; folate deficiency was defined as RBC folate <340 nmol/L. Linear and binomial regression models were used to examine associations of micronutrient biomarkers with Hb levels and risk of anemia. A total of 75.5% of children were anemic and 2.9% had severe anemia. The prevalence of iron deficiency was 61.4% (69.5% after Thurman adjustment), 57.4% of children had IDA, and 9.7% had CRP > 5.0 mg/L. The prevalence of vitamin B12 deficiency was 17.0%, 41.8% of children had vitamin B12 insufficiency, and 19.9% had folate deficiency. Among anemic children, 84.5% had ≥1 micronutrient deficiency and 22.7% had ≥ 2 micronutrient deficiencies. Iron deficiency (RR: 2.15; 95% CI: 1.55, 2.99; P < 0.001), and vitamin B12 deficiency (RR: 1.32; 95% CI: 1.09, 1.60; P < 0.01) were associated with significantly increased risk of anemia. Findings indicate that the burden of anemia, iron deficiency, and vitamin B12 insufficiency were high in young children in Mumbai, India. Harvest Plus; AF was supported by the National Institutes of Health.

Source: Current Developments in Nutrition

DOI: 10.1093/cdn/nzaa053_033