TitleThe Impact of Altitude and Diet on Anemia in School-Aged Children in Lago San Pablo, Ecuador
AuthorsSmith J.L., Johnston N.P., Dearden K.A., Eggett D.L., Campbell A.K.
Publication. 2010 Oct;.

Childhood anemia is often complicated in developing nations by altitude-induced polycythemia, parasitosis, and dietary inadequacy; however, school-aged children are often overlooked in research and public health efforts. The objectives of this study were to determine the prevalence of anemia among school-aged children in rural Ecuador and to investigate the etiology of anemia in this population to assist program development. A cross-sectional design and cluster sampling was used to sample 347 children aged 5 to 12 years in 5 communities in the Andean region. Altitude ranged from 2795 to 3240 m above sea level. Data collection included health and diet questionnaires, fecal parasite and finger-stick hemoglobin analysis, and anthropometric measures. World Health Organization standards were applied to adjust hemoglobin for altitude and determine the rate of anemia. Parasitosis affected 95% of children tested but showed no statistical impact on anemia. Anemia prevalence rose from 15% to 65%, once adjusted for altitude. Significant factors affecting anemia included failure to adjust for altitude and low dietary intakes of vitamins A, B 12, folate, and zinc, with a minimal proportion of nutrients from animal-source foods. Dietary niacin and calcium were significantly correlated with the reduction of anemia (P < .05). Anemia prevention programs may benefit from increased emphasis on animal-source foods.