Anemia and intestinal parasite infection in school children in rural Vietnam

Asia Pac J Clin Nutr. 2007;16(4):716-23.

Abstract

Objectives: This study hypothesized that besides iron deficiency, intestinal parasites infection is also a determinant of anemia in schoolchildren in rural Vietnam.

Methods: 400 primary schoolchildren from 20 primary schools in Tam Nong district, a poor rural area in Vietnam, were randomly selected from enrollment lists. Venous blood (5ml) was collected in a cross sectional study and analyzed for hemoglobin (Hb), serum ferritin (SF), serum transferrin receptor (TfR), serum C-reactive protein (CRP) and total immunoglobulin E (IgE). Stools samples were examined for hookworm, Trichuris, and Ascaris infection. Logistic regression was used to assess the effect of intestinal parasites on anemia.

Results: The prevalence of anemia (Hb < 115g/l) was 25%. Iron deficiency (TfR > 8.5mg/L) occurred in 2% of the children. The prevalence of intestinal parasites was 92% with the highest prevalence for Trichuris (76%) and Ascaris (71%). More than 30% and 80% of the children showed an elevated CRP (> or = 8 mg/L) and IgE (> 90 IU/ml) concentration. Anemia status was borderline significantly associated with SF and not associated with TfR and CRP. The prevalence odds ratio for Trichuris infection was 1.96 (95% CI 1.07-3.59) and 2.00 (95% CI 1.08-3.65) with iron deficiency reflected by TfR and SF, respectively.

Conclusion: Anemia is highly prevalent among schoolchildren in Vietnam but may not be associated with iron deficiency. Trichuris infection is associated with a doubled risk of anemia, not mediated through iron deficiency. Chronic infection may play a role in anemia, but needs further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / epidemiology
  • Anemia / etiology
  • Anemia, Iron-Deficiency / epidemiology
  • Anemia, Iron-Deficiency / etiology*
  • C-Reactive Protein / analysis
  • Child
  • Cross-Sectional Studies
  • Feces / parasitology*
  • Female
  • Ferritins / analysis
  • Health Surveys*
  • Hemoglobins / analysis
  • Humans
  • Immunoglobulin E / blood
  • Intestinal Diseases, Parasitic / complications*
  • Intestinal Diseases, Parasitic / epidemiology
  • Iron / blood*
  • Iron Deficiencies
  • Logistic Models
  • Male
  • Odds Ratio
  • Prevalence
  • Receptors, Transferrin / analysis
  • Rural Health
  • Vietnam / epidemiology

Substances

  • Hemoglobins
  • Receptors, Transferrin
  • Immunoglobulin E
  • C-Reactive Protein
  • Ferritins
  • Iron