Blood Lead Levels in children 2 through 59 months old in Bhutan

Introduction: Pediatric lead exposure has long-term health, public health, and economic consequences; however, it is an underrecognized problem in low and middle-income countries. Our objective was to determine the prevalence of elevated blood lead levels (EBLLs) (greater than or equal to 5mg/dL) an...

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Main Authors: Phillip Erbele, Deki Pem, Phensum Tobgay, Sonam Pelden, Mongal S. Gurung, Sonam Ugen, Krista Erbele
Format: Article
Language:English
Published: Khesar Gyalpo University of Medical Sciences of Bh 2021-06-01
Series:Bhutan Health Journal
Online Access:https://bhj.com.bt/index.php/bhj/article/view/85
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author Phillip Erbele
Deki Pem
Phensum Tobgay
Sonam Pelden
Mongal S. Gurung
Sonam Ugen
Krista Erbele
author_facet Phillip Erbele
Deki Pem
Phensum Tobgay
Sonam Pelden
Mongal S. Gurung
Sonam Ugen
Krista Erbele
author_sort Phillip Erbele
collection DOAJ
description Introduction: Pediatric lead exposure has long-term health, public health, and economic consequences; however, it is an underrecognized problem in low and middle-income countries. Our objective was to determine the prevalence of elevated blood lead levels (EBLLs) (greater than or equal to 5mg/dL) and evaluate risk factors for EBLLs in infants and children in two cities in Bhutan. Methods: A cross-sectional study of children 2 through 59 months old was conducted in Thimphu and Phuentsholing, Bhutan during 2018. Blood was obtained by finger-stick and tested using a LeadCare II analyzer (Meridian Bioscience). Data were double entered in EpiData 3.1 and validated. Excel, Prism8, and STATA/IC 15.1 were used for analysis. Results: Among 531 participants, the prevalence of EBLLs was 43.88%. The prevalence of EBLLs in girls and boys was 37.40% (n=262) and 50.19% (n=269), respectively (p= 0.004). The prevalence in Thimphu was 52.35% (n=361), compared to 25.88% (n=170) in Phuentsholing (p less than 0.001). In Thimphu, 70.47% (n=149) of 1 - 4 year old children tested in spring had EBLLs, compared to 51.45% (n=138) in autumn (p=0.001). Of the risk factors assessed, only regularly eating with fingers or hands was significantly associated with EBLLs (p < 0.001). Conclusions: Nearly half of participants in two cities in Bhutan had elevated blood lead levels. Seasonal exposure to lead appears to be present. The high prevalence in this study is alarming. Further studies are urgently needed to both characterize the sources of lead and validate these findings on a larger scale.
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spelling doaj.art-c3ae3401571a4da1bb72a9d20fd06d7b2023-10-25T09:57:31ZengKhesar Gyalpo University of Medical Sciences of BhBhutan Health Journal2413-29932415-11142021-06-015271410.47811/bhj.8385Blood Lead Levels in children 2 through 59 months old in BhutanPhillip Erbele0https://orcid.org/0009-0008-0121-7160Deki Pem1https://orcid.org/0000-0003-3727-3806Phensum Tobgay2Sonam Pelden3Mongal S. Gurung4https://orcid.org/0000-0001-6481-6242Sonam Ugen5Krista Erbele6Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan.Faculty of Nursing & Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, BhutanFaculty of Nursing & Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, BhutanJigme Dorji Wangchuck National Referral Hospital, Thimphu, BhutanMinistry of Health, Thimphu, Bhutan Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan International Partnership for Sustainable Advances in Health and Development, Lancaster, PA, USAIntroduction: Pediatric lead exposure has long-term health, public health, and economic consequences; however, it is an underrecognized problem in low and middle-income countries. Our objective was to determine the prevalence of elevated blood lead levels (EBLLs) (greater than or equal to 5mg/dL) and evaluate risk factors for EBLLs in infants and children in two cities in Bhutan. Methods: A cross-sectional study of children 2 through 59 months old was conducted in Thimphu and Phuentsholing, Bhutan during 2018. Blood was obtained by finger-stick and tested using a LeadCare II analyzer (Meridian Bioscience). Data were double entered in EpiData 3.1 and validated. Excel, Prism8, and STATA/IC 15.1 were used for analysis. Results: Among 531 participants, the prevalence of EBLLs was 43.88%. The prevalence of EBLLs in girls and boys was 37.40% (n=262) and 50.19% (n=269), respectively (p= 0.004). The prevalence in Thimphu was 52.35% (n=361), compared to 25.88% (n=170) in Phuentsholing (p less than 0.001). In Thimphu, 70.47% (n=149) of 1 - 4 year old children tested in spring had EBLLs, compared to 51.45% (n=138) in autumn (p=0.001). Of the risk factors assessed, only regularly eating with fingers or hands was significantly associated with EBLLs (p < 0.001). Conclusions: Nearly half of participants in two cities in Bhutan had elevated blood lead levels. Seasonal exposure to lead appears to be present. The high prevalence in this study is alarming. Further studies are urgently needed to both characterize the sources of lead and validate these findings on a larger scale.https://bhj.com.bt/index.php/bhj/article/view/85
spellingShingle Phillip Erbele
Deki Pem
Phensum Tobgay
Sonam Pelden
Mongal S. Gurung
Sonam Ugen
Krista Erbele
Blood Lead Levels in children 2 through 59 months old in Bhutan
Bhutan Health Journal
title Blood Lead Levels in children 2 through 59 months old in Bhutan
title_full Blood Lead Levels in children 2 through 59 months old in Bhutan
title_fullStr Blood Lead Levels in children 2 through 59 months old in Bhutan
title_full_unstemmed Blood Lead Levels in children 2 through 59 months old in Bhutan
title_short Blood Lead Levels in children 2 through 59 months old in Bhutan
title_sort blood lead levels in children 2 through 59 months old in bhutan
url https://bhj.com.bt/index.php/bhj/article/view/85
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