Anemia Etiology in the Peruvian Amazon: a cross-sectional study

Abstract

Background: Understanding the multifactorial causes of anemia on a population level is important for creating effective interventions that mitigate poor health outcomes associated with anemia, particularly in regions where these rates are highly elevated. This study aims to quantify the relative prevalence of iron deficiency anemia, anemia of inflammation, and micronutrient deficiency anemia within 2 – 11 year olds in Madre de Dios (MDD), Peru, where anemia rates are estimated to be between 40 and 50%. It further aims to assess varying risk factors for given etiologies by community type, particularly as many communities in this region experience varied exposure to gold-mining related methylmercury. Methods: Eight communities along the Madre de Dios River, within the Peruvian Amazon, were selected in order to screen 2 – 11 year olds for anemia. Those qualifying as anemic were invited to provide venous blood samples for iron level, inflammation, and nutrition biomarker analyses in order to differentiate between these anemia etiologies. Health history and household characteristics were gathered in survey format, and analyzed in relation to gathered biomarkers. Results: Overall anemia prevalence (18.5%) was significantly decreased from previous studies. 14.9% were iron deficient, 12.8% showed signs of inflammation, and 12.8% were Vitamin B12 deficient. Anemia prevalence varied significantly by sex. Risk factors for anemia did not vary significantly by community type, other than increased annual income in urban and mining communities, and a reduced likelihood for having been born prematurely within mining communities. Conclusions: Peru’s multi-sectoral approach to reducing anemia has shown promising results in MDD. Health determinant variations have proven largely insignificant for anemia outcomes within the screened communities.