PloS one · 2026
Changes in anemia prevalence and the proportion of anemia associated with iron deficiency or inflammation in young children residing in Puno, Peru: Analysis using new World Health Organization guidelines for defining anemia.
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Vásquez-Velásquez Cinthya, Choque-Quispe Benita Maritza, Suchdev Parminder S, Rees Chris A, Tapia Vilma, Ko Yi-An, Gonzales Gustavo F
Аннотация
BACKGROUND: In 2024, the World Health Organization (WHO) introduced new hemoglobin cutoffs for diagnosing anemia. The WHO also incorporated revised altitude adjustments and lowered thresholds to diagnose anemia for children aged 6-23 months. Puno, Peru has historically reported the highest prevalence of anemia in the country, exceeding 70% in infants and young children.
OBJECTIVE: To assess the impact of the new WHO cutoffs on anemia prevalence and evaluate whether they affected the proportion of anemia attributable to iron deficiency (ID), inflammation, and other causes.
METHODS: A cross-sectional study was conducted among 310 children aged 6-59 months in Puno, Peru. Participants were recruited via convenience sampling during routine medical check-ups. Venous blood samples were analyzed using an automated hemoglobin analyzer and serum biomarker evaluations. Anemia prevalence was determined based on WHO guidelines for children aged 6-59 months (and 6-23 months and 24-59 months as subgroups). The ratio of anemia due to ID (Ferritin <12 ng/mL) or inflammation (IL-6 > 60 pg/mL) was estimated using adjusted Poisson regression models, reporting prevalence ratios (PR).
RESULTS: Applying the new WHO guidelines, anemia prevalence changed from 50% to 42.2% in children aged 6-59 months (62% to 47% in children aged 6-23 months and from 45.9% to 40.6% in children aged 24-59 months). The proportion of anemia due to ID was 27.5%, due to inflammation was 45.9%, and due to other causes was 26.6%. ID was significantly associated with anemia in both unadjusted and adjusted analyses (PR: 1.4, 95% CI: 1.1-1.8; PR: 1.32, 95% CI: 1.0-1.7). The 2024 WHO guidelines did not substantially alter the estimated proportion of anemia associated with ID or inflammation.
CONCLUSIONS: Application of the new WHO cutoffs resulted in a lower estimated prevalence of anemia among young children. ID accounted for only a small proportion of cases of anemia, emphasizing the need for further research into other causes of childhood anemia in Peru.
OBJECTIVE: To assess the impact of the new WHO cutoffs on anemia prevalence and evaluate whether they affected the proportion of anemia attributable to iron deficiency (ID), inflammation, and other causes.
METHODS: A cross-sectional study was conducted among 310 children aged 6-59 months in Puno, Peru. Participants were recruited via convenience sampling during routine medical check-ups. Venous blood samples were analyzed using an automated hemoglobin analyzer and serum biomarker evaluations. Anemia prevalence was determined based on WHO guidelines for children aged 6-59 months (and 6-23 months and 24-59 months as subgroups). The ratio of anemia due to ID (Ferritin <12 ng/mL) or inflammation (IL-6 > 60 pg/mL) was estimated using adjusted Poisson regression models, reporting prevalence ratios (PR).
RESULTS: Applying the new WHO guidelines, anemia prevalence changed from 50% to 42.2% in children aged 6-59 months (62% to 47% in children aged 6-23 months and from 45.9% to 40.6% in children aged 24-59 months). The proportion of anemia due to ID was 27.5%, due to inflammation was 45.9%, and due to other causes was 26.6%. ID was significantly associated with anemia in both unadjusted and adjusted analyses (PR: 1.4, 95% CI: 1.1-1.8; PR: 1.32, 95% CI: 1.0-1.7). The 2024 WHO guidelines did not substantially alter the estimated proportion of anemia associated with ID or inflammation.
CONCLUSIONS: Application of the new WHO cutoffs resulted in a lower estimated prevalence of anemia among young children. ID accounted for only a small proportion of cases of anemia, emphasizing the need for further research into other causes of childhood anemia in Peru.