Emily Hughes Siegel, Bloomberg School of Public Health, Johns Hopkins University, 221 West Lanvale Street, Apt. 2R, Baltimore, MD 21217, 410-728-5212, esiegel@jhsph.edu

Risk factors for anemia have not been characterized for young children in rural Nepal. We described the distribution of hemoglobin and prevalence of anemia in 569 4- to 17-month Nepali children by age, sex, caste, socio-economic status, morbidity, anthropometry, and dietary indicators. Participants were identified from census data collected in one of 30 village development committees (VDCs) in Sarlahi District and enrolled in a placebo-controlled, randomized clinical trial between January and March 2002. Hemoglobin and erythrocyte protoporphyrin (EP) were measured at baseline using a heel prick technique. The mean hemoglobin concentration was 101 g/L +/- 12.5. Among the young children, 60.3 % were anemic (hemoglobin < 105 g/L), 2.0% were severely anemic (hemoglobin < 7.0 g/L), and 74% of the anemic cases were associated with iron deficiency (EP < 70 umol/mol). Growth was delayed; 30.8% were stunted, 18.1% were wasted, and 50.7% were underweight. Bivariate analyses revealed age, caste, socio-economic status, dietary diversity, acute respiratory infection, stunting, and underweight to be associated with hemoglobin concentration and/or anemia. We did not observe sex differences to be present. In multivariate models, age and caste were found to be strong predictors of both hemoglobin concentration and anemia. The 15- to 17-month age group and the three caste groups remained significant (p < 0.05) after controlling for EP. We conclude that moderate anemia is a serious problem among infants in the first two years of life living in rural, southeast central Nepal.

Learning Objectives:

• In developing countries where a myriad of factors affects the health of young children, the epidemiology of anemia varies substantially between ecological and socio-cultural settings. Our objective is to guide the development and targeting of appropriate interventions to combat anemia in a setting representative of southern Nepal and northern India.

Keywords: Epidemiology, Anemia

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.