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Prevalence of Iron Deficiency and its Sociodemographic Patterning in Indian Children and Adolescents: Findings from the Comprehensive National Nutrition Survey 2016-18.

Authors :
Kulkarni, Bharati
Peter, Rajini
Ghosh, Santu
Pullakhandam, Raghu
Thomas, Tinku
Reddy, G Bhanuprakash
Rajkumar, Hemalatha
Kapil, Umesh
Deb, Sila
Johnston, Robert
Agrawal, Praween K
De Wagt, Arjan
Kurpad, Anura V
Sachdev, Harshpal Singh
De Wagt, Arjan
Source :
Journal of Nutrition. Aug2021, Vol. 151 Issue 8, p2422-2434. 13p.
Publication Year :
2021

Abstract

<bold>Background: </bold>Anemia control programs in India focus mainly on the measurement of hemoglobin in response to iron-folic acid supplementation. However, representative national estimates of iron deficiency (ID) are not available.<bold>Objectives: </bold>The objective of the present study was to evaluate ID prevalence among children and adolescents (1-19 y) using nationally representative data and to examine the sociodemographic patterning of ID.<bold>Methods: </bold>Cross-sectional data from the Comprehensive National Nutrition Survey in children (1-4 y: n = 9635; 5-9 y: n = 11,938) and adolescents (10-19 y; n = 11,507) on serum ferritin (SF) and other biomarkers were analyzed to determine inflammation-adjusted ID prevalence [SF (μg/L): <12 in 1-4 y and <15 in 5-19 y] and its relation to sociodemographic indicators. Multiple-regression analyses were conducted to identify the exposure associations of iron status. In addition, the relation between SF and hemoglobin was assessed as an indicator of iron utilization in different wealth quintiles.<bold>Results: </bold>ID prevalence was higher in 1- to 4-y-old children (31.9%; 95% CI: 31.0%, 32.8%) and adolescent girls (30.4%; 95% CI: 29.3%, 31.5%) but lower in adolescent boys and 5- to 9-y-old children (11%-15%). In all age groups, ID prevalence was higher in urban than in rural participants (1-4 y: 41% compared with 29%) and in those from richer quintiles (1-4 y: 44% in richest compared with 22% in poorest), despite adjustment for relevant confounders. SF significantly interacted with the wealth index, with declining trends in the strength of association between hemoglobin and SF from the richest to the poorest groups suggesting impaired iron utilization for hemoglobin synthesis in poorer wealth quintiles.<bold>Conclusions: </bold>ID prevalence was indicative of moderate (in preschool children and adolescent girls) or mild (in 5- to 9-y-old children and adolescent boys) public health problem with significant variation by state and age. Focusing on increasing iron intake alone, without addressing the multiple environmental constraints related to poverty, may not result in intended benefits. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00223166
Volume :
151
Issue :
8
Database :
Academic Search Index
Journal :
Journal of Nutrition
Publication Type :
Academic Journal
Accession number :
151839133
Full Text :
https://doi.org/10.1093/jn/nxab145