Low prevalence of iron-deficiency anaemia among Inuit preschool children: Nunavut Inuit Child Health Survey, 2007–2008

Abstract

Objective: To report the prevalence rates and correlates for anaemia, iron deficiency (ID) and iron-deficiency anaemia (IDA) among Inuit preschool-aged children. Design: A cross-sectional study assessed iron intake, demographic information, medical history, anthropometrics, Hb, ferritin, C-reactive protein and antibodies to Helicobacter pylori. Setting: Sixteen selected Inuit communities in Nunavut Territory, Canada. Subjects: Inuit (n 388) aged 3-5 years randomly recruited from communities. Results: Anaemia (3-4 years: Hb , 110 g/l; 5 years: Hb , 115 g/l) was prevalent in 16?8 % of children. The prevalence of ID (ferritin , 12 mg/l) was 18?0 % and that of IDA was 5?4 %. When ID was defined as ferritin ,10 mg/l, 10?8 % of children were iron deficient and 3?3 % had IDA. In multiple logistic regression, boys were more likely to be iron deficient (OR 5 2?28, 95 % CI 1?17, 8?25), but no other risk factor emerged for ID. Three-to 4-year-olds were less likely than 5-year-olds to have anaemia from causes other than ID (OR 5 0?11, 95 % CI 0?08, 0?58). Anaemia from other causes was more common among children residing in crowded homes (OR 5 2?30, 95 % CI 1?37, 12?31) and those treated for past-year ear infection (OR 5 1?35, 95 % CI 1?05, 7?21). Conclusions: The low prevalence of ID and IDA is encouraging, but efforts are still needed to reduce rates as they continue to be higher than general population rates. Household crowding and infections may contribute to anaemia and warrant further research.

Traditional food and monetary access to market-food: correlates of food insecurity among Inuit preschoolers

“…Iron deficiency was defined by a ferritin less than 12 µg/l and restricted to those with hsCRP <8ng/ml. In an earlier report, the weighted prevalence of anemia assessed by venous blood Hb only, iron defi-Food insecurity in Nunavut ciency and iron deficiency anemia was 16.8%, 18.0% and 5.4%, respectively (12). Past-month TF consumption (≥19 times/mo.…”

“…vs. <19 times/ mo.) and food security was not related to iron deficiency, iron deficiency anemia or to anemia attributed to causes other than low-iron status (12). The analyses presented herein represent analyses of total anemia and iron deficiency by past-day TF consumption and by food security status.…”

“…Hemoglobin (Hb) was ascertained in the field with either a venous or capillary blood sample using the HemoCue TM 201+ portable photometer (HemoCue, Inc., Lake Forest, CA, USA): methodological details are presented elsewhere (12). Ferritin was measured from plasma samples using an autoanalyzer (Liason®, DiaSorin, Saluggia, Italy) and high-sensitivity Creactive protein (hsCRP) was measured using a SYNCHRON® Autoanalyzer (Coulter Beckman, USA) and an hsCRP assay at the Montreal Children's General Hospital, Montreal, Canada (12). Anemia for 3-4 year-olds was present when Hb was less than 110 g/l and for 5 year-olds when Hb was less than 115 g/l.…”

“…Therefore, data from the Nunavut Inuit Child Health Survey (1) were further evaluated to determine the household and nutritional characteristics associated with food insecurity and the extent to which consumption of TF could ameliorate the nutritional impact of food insecurity in the Arctic. The survey, to date, provides the first comprehensive evaluation of the nutritional status and socio-economic indicators of health and well-being of Inuit preschoolers in Canada's Nunavut Territory; details of study findings to date are presented elsewhere (1,(9)(10)(11)(12).…”

Iron supplementation for children: Safety in all settings is not clear

“…In Canada, there are reports of a high prevalence of anemia in some remote aboriginal communities, 3 but these reports tend to be from settings where foods that are complementary to breastfeeding are low in iron; preschool Inuit children have low rates of iron deficiency anemia. 4 Because so few children in Canada are anemic, population-level interventions are obviously not advised for primaryschool-aged children.…”