Analyzing data from national health surveys and published academic studies, researchers in Spain concluded that a deficiency of red blood cells, also known as anemia, is a ‘mild to moderate’ public health concern among children in South American and Caribbean countries.
Overall, there was a prevalence of 28.56% of childhood anemia in the cultural geographic region, but “this percentage conceals very different realities,” according to the authors.
The highest rate of anemia was found in Latin Caribbean countries, where prevalence in Haiti is 70%, while countries like Ecuador and Costa Rica with 3.5% and 4% prevalence respectively, help drive down the region’s average.
Researchers from the Universitat Rovira I Virgili in Reus, Spain, who authored the study, found a link between government nutritional interventions and reduced anemia levels.
Argentina, Chile, and Costa Rica, for example, had successful programs for food fortification and iron supplement distribution.
Meanwhile, Haiti, which has the highest prevalence of anemia, “has never established a national plan to reduce anemia, and it has been documented that interventions with milk or complementary foods fortified with iron have generally not been successful.”
Their study was published in the January 2019 edition of the journal Nutrients.
Not just nutritional interventions
In addition to fortification and supplement distribution programs, the authors found success in countries that put in place measures that influence social and household environments, which was correlated to anemia in children.
For example, Mexico and Peru put in place comprehensive plans involving health services, nutritional and health education, and even cash transfers. Anemia prevalence dropped 18 percentage points in Mexico since the program was put in place, while in Peru dropped 40 percentage points.
Some countries didn’t find the same success when it comes to government interventions. Brazil’s childhood anemia prevalence exceeded 40%, and the authors argued that low coverage and inadequate compliance with the National Iron Supplement Program approved by the government in 2005 was cause for its still widespread childhood anemia status.
There was surprisingly no significant difference when controlled for urban versus rural children, though childhood anemia was slightly more prevalent among rural children.
They postulated that, despite the diet of children living in cities possibly being wider and more varied than in rural areas, urban children are increasingly eating processed foods rich in sugars and fats, which do not contain a sufficient amount of iron.
The researchers collected studies on anemia in Latin America published through December 2018, as well as national survey results by health authorities in multiple Latin American countries and international organizations such as UNICEF and the WHO.
“To date, knowledge about the prevalence of anemia in preschool and school-age children in Latin American and Caribbean countries has been made up of isolated data for each country,” they wrote.
After data collection, the researchers conducted a systematic review, which means summarizing results from available studies. They also conducted a meta-analysis—examination of data from a number of independent studies of the same subject—on the effectiveness of nutritional interventions.
Out of the 61 studies included for analysis, 14 of them focused on nutritional intervention programs designed to address anemia prevalence.
These national plans analyzed, targeting infants and school-age children, were carried out between 1997 and 2000 in Costa Rica, Cuba, Dominican Republic, Chile, Ecuador, and Mexico.
“Following the nutritional intervention programs, some countries continued to have high rates of anemia, while other reduced its prevalence significantly,” they wrote.
They noted that programs designed at a national level with great coverage, well monitored, and extended over time had greater success in reducing the prevalence of childhood anemia in Latin American and Caribbean countries.
Published online ahead of print, doi:10.3390/nu11010183
“Prevalence of Anemia in Children from Latin America and the Caribbean and Effectiveness of Nutritional Interventions: Systematic Review and Meta–Analysis”
Authors: Lucía Iglesias Vázquez, et al.