© 2003 by Oxford University Press
Anemia and Iron Deficiency among Schoolchildren in the Aral Sea Region, Kazakhstan
1 Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan 2 Division of Epidemiology and Biostatistics, National Cancer Center Research Institute, Chiba, Japan 3 Faculty of Home Economics, Kyushu Women's University, Kitakyushu, Japan 4 National Children's Rehabilitation Center, Almaty, Kazakhstan 5 Ministry of Health, Kzyl-Orda, Kazakhstan 6 Department of Biochemistry, Kazakh State Medical University, Almaty, Kazakhstan 7 II Municipal Hospital, Chimkent, Kazakhstan 8 TRI. STAN, London, UK 9 Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan 10 Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan
The objectives of this study were to estimate the prevalence of anemia and iron deficiency among schoolchildren in the Aral Sea region of Kazakhstan and to determine the various factors associated with anemia in this population. We conducted a cross-sectional study of randomly selected schoolchildren. Blood samples were collected for measuring hemoglobin (Hb), serum ferritin (SF), total iron binding capacity (TIBC), and other hematological indices, and subjects were screened for anemia and iron deficiency. Associations between Hb concentration and SF, TIBC, anthropometric, and socioeconomic data were evaluated using regression analysis. The prevalence of anemia was 49.8 per cent although levels were mostly mild. Twenty-two per cent of the children were iron depleted (SF < 12 µg/l). Of the anemic children, 32.4 per cent were found to have iron deficiency anemia (anemia with SF < 12 µg/l). There were significant positive correlations between the levels of Hb and SF, but a negative correlation with serum TIBC. Age, mean corpuscular volume (MCV) and SF were found to be significantly related to Hb by stepwise multiple regression analysis. Multiple logistic regression analysis revealed that anemia was independently related to living district, education of father, and child's age. The results suggest that iron deficiency is an important determinant of anemia in this population; however, whole anemia cannot be solely explained by iron deficiency. Further studies are needed for consideration of micronutrients status, parasite infestation, hereditary disorders, and exposure to environmental pollutants.