Determinants of Anemia among Young Children in Western Kenya

Background More than 65% of Kenyan children < 3 years of age are anemic. Although most of this anemia has been attributed to iron deficiency, limited data are available on other potential nutritional, infectious and genetic etiologies to guide anemia prevention and treatment programs. Methods We conducted a cross‐sectional survey of 858 children aged 6–35 months randomly selected from 60 villages in western Kenya. Hemoglobin (Hb), transferrin receptor (TfR), retinol binding protein (RBP), malaria parasitemia, C‐reactive protein (CRP), and anthropometry were measured. Results Anemia (Hb<11.0 g/dL) was detected in 71.6% of children. Anemia was associated with iron deficiency (TfR>8.3 mg/L), malaria, inflammation (CRP>10 mg/L), stunting (ht‐for‐age z <‐2) and wasting (wt‐for‐ht z <‐2). In multivariate analysis, factors associated with anemia included elevated TfR (OR 5.0, p<0.01), malaria parasitemia (2.3, p<0.01), stunting (1.8, p<0.01), CRP (1.1, p<0.01), child age (0.96, p<0.01) and male sex (0.7, p=0.04). Conclusions The major predictor of anemia was iron deficiency; however, malaria, chronic malnutrition, and elevated CRP were also important predictors. Interventions for preventing anemia should utilize an integrated approach, ensuring optimal iron intake and simultaneously addressing malaria and other infections.