Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey

<p>Background: Iron deficiency, the most common micronutrient disorder and cause of anaemia globally, impairs growth, cognition, behaviour and resistance to infection.</p><p> Methods/Results: As part of a national survey of inherited haemoglobin variants in 7526 students from 72 s...

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Main Authors: Allen, A, Allen, S, Rodrigo, R, Perera, L, Shao, W, Li, C, Wang, D, Olivieri, N, Weatherall, D, Premawardhena, A
Format: Journal article
Published: Public Library of Science 2017
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author Allen, A
Allen, S
Rodrigo, R
Perera, L
Shao, W
Li, C
Wang, D
Olivieri, N
Weatherall, D
Premawardhena, A
author_facet Allen, A
Allen, S
Rodrigo, R
Perera, L
Shao, W
Li, C
Wang, D
Olivieri, N
Weatherall, D
Premawardhena, A
author_sort Allen, A
collection OXFORD
description <p>Background: Iron deficiency, the most common micronutrient disorder and cause of anaemia globally, impairs growth, cognition, behaviour and resistance to infection.</p><p> Methods/Results: As part of a national survey of inherited haemoglobin variants in 7526 students from 72 secondary schools purposefully selected from the 25 districts of Sri Lanka, we studied 5912 students with a normal haemoglobin genotype. Median age was 16.0 (IQR 15.0–17.0) years and 3189 (53.9%) students were males. Most students were Sinhalese (65.7%), with fewer Tamils (23.1%) and Muslims (11.2%). Anaemia occurred in 470 students and was more common in females (11.1%) than males (5.6%). Haemoglobin, serum ferritin, transferrin receptor and iron were determined in 1196 students with low red cell indices and a structured sample of those with normal red cell indices (n = 513). The findings were weighted to estimate the frequencies of iron deficiency and iron deficiency anaemia classified according to WHO criteria. Iron depletion (serum ferritin &lt;15ug/ml) occurred in 19.2% and cellular iron deficiency (low serum ferritin and transferrin receptor &gt;28.1 nmol/l) in 11.6% students. Iron deficiency anaemia (cellular iron deficiency with low haemoglobin) occurred in only 130/2794 (4.6%) females and 28/2789 (1.0%) males. Iron biomarkers were normal in 83/470 (14.6%) students with anaemia. In multiple regression analysis, the odds for iron depletion and cellular iron deficiency were about one-third in males compared with females, and the odds for iron deficiency anaemia were about one fifth in males compared to females. Tamil ethnicity and age &lt;16 years increased the risk of all three stages of iron deficiency and living at high altitude significantly reduced the risk of iron depletion.</p><p> Conclusions: Low iron status and anaemia remain common problems in Sri Lankan secondary school students especially females, younger students and the socioeconomically disadvantaged Tamil population. More research is needed to identify factors other than low iron status that contribute to anaemia in adolescents.</p>
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spelling oxford-uuid:e58f40a3-e8f2-4d0f-9102-ed02c5669dcf2022-03-27T10:25:03ZIron status and anaemia in Sri Lankan secondary school children: A cross-sectional surveyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e58f40a3-e8f2-4d0f-9102-ed02c5669dcfSymplectic Elements at OxfordPublic Library of Science2017Allen, AAllen, SRodrigo, RPerera, LShao, WLi, CWang, DOlivieri, NWeatherall, DPremawardhena, A<p>Background: Iron deficiency, the most common micronutrient disorder and cause of anaemia globally, impairs growth, cognition, behaviour and resistance to infection.</p><p> Methods/Results: As part of a national survey of inherited haemoglobin variants in 7526 students from 72 secondary schools purposefully selected from the 25 districts of Sri Lanka, we studied 5912 students with a normal haemoglobin genotype. Median age was 16.0 (IQR 15.0–17.0) years and 3189 (53.9%) students were males. Most students were Sinhalese (65.7%), with fewer Tamils (23.1%) and Muslims (11.2%). Anaemia occurred in 470 students and was more common in females (11.1%) than males (5.6%). Haemoglobin, serum ferritin, transferrin receptor and iron were determined in 1196 students with low red cell indices and a structured sample of those with normal red cell indices (n = 513). The findings were weighted to estimate the frequencies of iron deficiency and iron deficiency anaemia classified according to WHO criteria. Iron depletion (serum ferritin &lt;15ug/ml) occurred in 19.2% and cellular iron deficiency (low serum ferritin and transferrin receptor &gt;28.1 nmol/l) in 11.6% students. Iron deficiency anaemia (cellular iron deficiency with low haemoglobin) occurred in only 130/2794 (4.6%) females and 28/2789 (1.0%) males. Iron biomarkers were normal in 83/470 (14.6%) students with anaemia. In multiple regression analysis, the odds for iron depletion and cellular iron deficiency were about one-third in males compared with females, and the odds for iron deficiency anaemia were about one fifth in males compared to females. Tamil ethnicity and age &lt;16 years increased the risk of all three stages of iron deficiency and living at high altitude significantly reduced the risk of iron depletion.</p><p> Conclusions: Low iron status and anaemia remain common problems in Sri Lankan secondary school students especially females, younger students and the socioeconomically disadvantaged Tamil population. More research is needed to identify factors other than low iron status that contribute to anaemia in adolescents.</p>
spellingShingle Allen, A
Allen, S
Rodrigo, R
Perera, L
Shao, W
Li, C
Wang, D
Olivieri, N
Weatherall, D
Premawardhena, A
Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title_full Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title_fullStr Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title_full_unstemmed Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title_short Iron status and anaemia in Sri Lankan secondary school children: A cross-sectional survey
title_sort iron status and anaemia in sri lankan secondary school children a cross sectional survey
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