We studied the prevalence of low haematocrit values (defined as <38%) in 1,253 children from urban and rural areas of Guatemala, to examine any urban-rural or age-related trends. Though the crude prevalences of low haematocrit for all the children showed a significant difference between urban and rural residents, the significance disappeared when these values were adjusted for differences in the age profiles of the two groups. As expected, preschool children had significantly more low haematocrits (32.0%) than school-age children (6.0%) (p < .05). Ferritin levels were available for 35.9% of the preschool children (one urban and one rural location); of these, 51.8% had levels below 12 mg/l, indicating iron deficiency. These values were used to determine the predictive value of haematocrit compared with ferritin values, and the cut-off at which haematocrit reaches optimum sensitivity and specificity to diagnose iron depletion. A cut-off of 39% had a sensitivity of 61% and a specificity of 45% in urban preschoolers, and a cut-off of 38% had a sensitivity of 75% and specificity of 42% in rural preschoolers.
References
1.
HussainA.M., LunvenP.Urbanization and hunger in the citiesFood Nutr Bull1987; 9(4) 4: 50–61.
2.
PopkinB.M., BisgroveE.Z.Urbanization and nutrition in low-income countriesFood Nutr Bull1988; 10(1): 3–28.
3.
ViteriF.E.Nutrition-related health consequences of urbanizationFood Nutr Hull1987; 9(4): 33–49.
4.
MottK.E., DejjeuxA., ManoyoAParasitic diseases and urban developmentBull WHO1990; 68(6): 691–8.
5.
Rossi-EspagnetA.Health services and environmental factors in urban slums and shanty towns of the developing world. Food Nutr Bull1987; 9(4): 4–20
6.
MusgroveP.Basic food consumption in north-east Brazil: effects of income, price, and family size in metropolitan and rural areas. Food Nutr Bull1988; 10(1): 29–38.
7.
De MaeyerE.M.Preventing and controlling iron deficiency anaemia through primary health care: a guide for health administrators and program managers.Geneva: WHO, 1989.
8.
CookJ.D., ClementA., FinchC.A.Assessing iron status of a population. Am J Clin Nutr1979; 32: 2115–19.
9.
ViteriF.E., De TunaV., GuzmanM.A.Normal haematological values in the Central American population. Brit J Haematol1972; 23: 189–204.
10.
World Health Organization.Nutritional anemia: report of a WHO scientific group. Technical Report Series, no. 405.Geneva: WHO, 1968
11.
TuftsD.A., HaasJ.D., BeardJ.L., SpielvogelH.Distribution of hemoglobin and functional consequences of anemia in adult males at high altitude. Am J Clin Nutr1985; 42: 111.
12.
Interdepartmental Committee for Nutrition in National Development.Evaluación nutricional de la población de Centro América y Panama: Guatemala.Guatemala City: INCAP, 1969.
13.
RuzM., RosasA., BuluxJHaematological status of school children in two regions of Guatemala: relevance of normality standards. Int J Food Nutr1992; 43: 89–95.
14.
MilesL.E.M., LipschitzD.A., BieberC.P., CookJ.D.Measurement of serum ferritin by a 2-site immunoradiometric assay. Anal Biochem1974; 61: 20924.
15.
ColtonT.Statistics in medicine.Boston, Mass, USA: Little Brown, 1974.
MausnerJ.S., BahnA.K.Epidemiology: an introductory text.Philadelphia, Pa, USA: W. B. Saunders, 1994.
18.
WHO Expert Scientific Working Group.Summary of a report on assessment of the iron nutritional status of the United States population. Am J Clin Nutr1985; 42: 1318–30.
19.
ViteriF.E., GuzmanM.A.Hematological status of the Central American population: prevalence of individuals with haemoglobin levels below normal. Brit J Haematol1972; 23: 725–35.
20.
LiraP.I.C., CartagenaH.A., de MelloREstado nutricional de crianças menores de seis anos, segundo posse da terra, em areas rurais do estado de Pernambuco, nordeste do Brasil. Arch Latinoam Nutr1985; 35(2): 247–57
21.
SigulemD.M., TudiscoE.S., Paiva de RodriguezE., Guerra de CamposC.C.Anemia nutricional y parasitosis intestinal en menores de 5 años. Rev Paul Med1985; 103(6): 308–12.
22.
TershakoveeA.M., WellerS.C.Iron status of inner-city elementary school children: lack of correlation between anemia and iron deficiency. Am J Clin Nutr1991; 54: 1071–6.
23.
AnourE., HasinM., YodfatY.[Anemia in Jerusalem children aged 3–6 years]. Harefuah1992; 123: 373–6.
24.
RamanL., PawasheA.B., RamalakshmiB.A.Iron nutritional status of preschool children. Indian J Ped1992; 59: 209–12.
25.
JalaludinB., TaylorR., LevyS., MontavilleB., GeeK.Prevalence of anaemia and iron deficiency at different levels of urbanization in Vanuatu. Papua New Guinea Med J1992; 35: 128–35.
26.
MollaA., KhurshidM., MollaA.M.Prevalence of iron deficiency anaemia in children of the urban slums of Karachi. J Pakistan Med Assoc1992; 42: 118–21.
27.
HongoT., SuzukiT., OhbaTNutritional assessment of a group of Japanese elementary school children in Tokyo: with special emphasis on growth, anemia and obesity. J Nutr S Vitaminol1992; 38: 177–96.
28.
WesthuyzenJ., SteynN.P.Hematological nutrition of schoolchildren in the far northwestern Cape. Trop Geogr Med1992; 44: 47–51.
29.
Abellan-RipoliA., Alcaraz-QuinoneroM., Mengual-CosM[Prevalence of iron deficiency and iron deficiency anemia in infancy and related factors in a community of the Murcia region]. Anales Españoles de Pediatría1992; 36: 265–8.
30.
LehmannF., Gray-DonaldK., MongeonM., Di TommasoS.Iron deficiency anemia in l-year-old children of disadvantaged families in Montreal. J Can Med Assoc1992; 146: 1571–7.
31.
BastaS.S., SoekimanM.S., KaryadiD., ScrimshawN.S.Iron deficiency anemia and the productivity of adult males in Indonesia. Am J Clin Nutr1979; 32: 916–25.
32.
ViteriF.E., TorunB.Anemia and physical work capacity. Clin Hematol1974; 3: 609–24.
33.
PollittE., Saco-PollittC., RudolphL.L., ViteriE.F.Iron deficiency and behavioral development in infants and preschool children. Am J Clin Nutr1986; 43: 555–65.
34.
LozoffB., BrittenhamG.M., WolfAWIron deficiency anemia and iron therapy effect on infant development test performance. Pediatrics1987; 79: 98195.
35.
DallmanP.R.Iron deficiency and the immune response. Am J Clin Nutr1987; 46: 329–34.
36.
GarbyL., IrnellL., WernerI.Iron deficiency in women of fertile age in a Swedish community: III. Estimation of prevalence based on response to iron supplementation. Acta Med Scand1969; 185: 113–17.
37.
SolomonsN.W.Urban nutrition in the tropics: a neglected subject of scientific inquiry. In: Gross R. Solomons NW, eds. Tropical urban nutrition.Eschborn, Germany: Gesellschaft für Technische Zusammenarbeit, 1987: 15–30.
