BACKGROUND: The World Health Organisation (WHO) suggests haemoglobin that (Hgb) cut-off levels below 2SD from the population mean to initiate anaemia investigations. In the absence of epidemiological data, Hgb less than 11 g/dL is considered abnormal in children up to the age of 59 months (4 years and eleven months). OBJECTIVES: This study reports on the Hgb cut-off levels among children at 1 and 4 years of age. The study compared the prevalence based on the WHO generic cut-off levels and population-specific cut-off-based value defined as below 2SD from the population mean. DESIGN, SETTINGS, AND PARTICIPANTS: A cross-sectional record-based study of healthy children below the age of 59 months attending primary care settings in Qatar. 3 years of Hgb data were collected and analysed using descriptive analyses. We excluded children with any pre-existing disease or who have altered biological parameters indicating a non-healthy child. RESULTS: 39407 Participants were stratified into different sub-groups according to age, gender, and ethnicity. Hgb levels were expressed as the mean ± 2SD for children of one and four years of age. Most children were from Western Asia (45.6%), followed by Northern Africa (23.7%), and Southern Asia (21.7%). Our findings for one-year-old children cut-off levels for anaemia might be as low as 9.9 g/dL and 10.6 g/dL for 4-years old. CONCLUSION: Hgb cut-off values may be set at higher levels for one-year and four-year age groups and many different ethnicities. Higher cut-off points may overestimate the problem as a public health issue. Children may be unnecessarily treated with iron or have needless investigations. AJBR
BACKGROUND: The World Health Organisation (WHO) suggests haemoglobin that (Hgb) cut-off levels below 2SD from the population mean to initiate anaemia investigations. In the absence of epidemiological data, Hgb less than 11 g/dL is considered abnormal in children up to the age of 59 months (4 years and eleven months). OBJECTIVES: This study reports on the Hgb cut-off levels among children at 1 and 4 years of age. The study compared the prevalence based on the WHO generic cut-off levels and population-specific cut-off-based value defined as below 2SD from the population mean. DESIGN, SETTINGS, AND PARTICIPANTS: A cross-sectional record-based study of healthy children below the age of 59 months attending primary care settings in Qatar. 3 years of Hgb data were collected and analysed using descriptive analyses. We excluded children with any pre-existing disease or who have altered biological parameters indicating a non-healthy child. RESULTS: 39407 Participants were stratified into different sub-groups according to age, gender, and ethnicity. Hgb levels were expressed as the mean ± 2SD for children of one and four years of age. Most children were from Western Asia (45.6%), followed by Northern Africa (23.7%), and Southern Asia (21.7%). Our findings for one-year-old children cut-off levels for anaemia might be as low as 9.9 g/dL and 10.6 g/dL for 4-years old. CONCLUSION: Hgb cut-off values may be set at higher levels for one-year and four-year age groups and many different ethnicities. Higher cut-off points may overestimate the problem as a public health issue. Children may be unnecessarily treated with iron or have needless investigations. AJBR
Authors: Nicholas Kassebaum; Hmwe Hmwe Kyu; Leo Zoeckler; Helen Elizabeth Olsen; Katie Thomas; Christine Pinho; Zulfiqar A Bhutta; Lalit Dandona; Alize Ferrari; Tsegaye Tewelde Ghiwot; Simon I Hay; Yohannes Kinfu; Xiaofeng Liang; Alan Lopez; Deborah Carvalho Malta; Ali H Mokdad; Mohsen Naghavi; George C Patton; Joshua Salomon; Benn Sartorius; Roman Topor-Madry; Stein Emil Vollset; Andrea Werdecker; Harvey A Whiteford; Kalkidan Hasen Abate; Kaja Abbas; Solomon Abrha Damtew; Muktar Beshir Ahmed; Nadia Akseer; Rajaa Al-Raddadi; Mulubirhan Assefa Alemayohu; Khalid Altirkawi; Amanuel Alemu Abajobir; Azmeraw T Amare; Carl A T Antonio; Johan Arnlov; Al Artaman; Hamid Asayesh; Euripide Frinel G Arthur Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Umar Bacha; Balem Demtsu Betsu; Aleksandra Barac; Till Winfried Bärnighausen; Estifanos Baye; Neeraj Bedi; Isabela M Bensenor; Adugnaw Berhane; Eduardo Bernabe; Oscar Alberto Bernal; Addisu Shunu Beyene; Sibhatu Biadgilign; Boris Bikbov; Cheryl Anne Boyce; Alexandra Brazinova; Gessessew Bugssa Hailu; Austin Carter; Carlos A Castañeda-Orjuela; Ferrán Catalá-López; Fiona J Charlson; Abdulaal A Chitheer; Jee-Young Jasmine Choi; Liliana G Ciobanu; John Crump; Rakhi Dandona; Robert P Dellavalle; Amare Deribew; Gabrielle deVeber; Daniel Dicker; Eric L Ding; Manisha Dubey; Amanuel Yesuf Endries; Holly E Erskine; Emerito Jose Aquino Faraon; Andre Faro; Farshad Farzadfar; Joao C Fernandes; Daniel Obadare Fijabi; Christina Fitzmaurice; Thomas D Fleming; Luisa Sorio Flor; Kyle J Foreman; Richard C Franklin; Maya S Fraser; Joseph J Frostad; Nancy Fullman; Gebremedhin Berhe Gebregergs; Alemseged Aregay Gebru; Johanna M Geleijnse; Katherine B Gibney; Mahari Gidey Yihdego; Ibrahim Abdelmageem Mohamed Ginawi; Melkamu Dedefo Gishu; Tessema Assefa Gizachew; Elizabeth Glaser; Audra L Gold; Ellen Goldberg; Philimon Gona; Atsushi Goto; Harish Chander Gugnani; Guohong Jiang; Rajeev Gupta; Fisaha Haile Tesfay; Graeme J Hankey; Rasmus Havmoeller; Martha Hijar; Masako Horino; H Dean Hosgood; Guoqing Hu; Kathryn H Jacobsen; Mihajlo B Jakovljevic; Sudha P Jayaraman; Vivekanand Jha; Tariku Jibat; Catherine O Johnson; Jost Jonas; Amir Kasaeian; Norito Kawakami; Peter N Keiyoro; Ibrahim Khalil; Young-Ho Khang; Jagdish Khubchandani; Aliasghar A Ahmad Kiadaliri; Christian Kieling; Daniel Kim; Niranjan Kissoon; Luke D Knibbs; Ai Koyanagi; Kristopher J Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Rachel Kulikoff; G Anil Kumar; Dharmesh Kumar Lal; Hilton Y Lam; Heidi J Larson; Anders Larsson; Dennis Odai Laryea; Janni Leung; Stephen S Lim; Loon-Tzian Lo; Warren D Lo; Katharine J Looker; Paulo A Lotufo; Hassan Magdy Abd El Razek; Reza Malekzadeh; Desalegn Markos Shifti; Mohsen Mazidi; Peter A Meaney; Kidanu Gebremariam Meles; Peter Memiah; Walter Mendoza; Mubarek Abera Mengistie; Gebremichael Welday Mengistu; George A Mensah; Ted R Miller; Charles Mock; Alireza Mohammadi; Shafiu Mohammed; Lorenzo Monasta; Ulrich Mueller; Chie Nagata; Aliya Naheed; Grant Nguyen; Quyen Le Nguyen; Elaine Nsoesie; In-Hwan Oh; Anselm Okoro; Jacob Olusegun Olusanya; Bolajoko O Olusanya; Alberto Ortiz; Deepak Paudel; David M Pereira; Norberto Perico; Max Petzold; Michael Robert Phillips; Guilherme V Polanczyk; Farshad Pourmalek; Mostafa Qorbani; Anwar Rafay; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Rajesh Kumar Rai; Usha Ram; Zane Rankin; Giuseppe Remuzzi; Andre M N Renzaho; Hirbo Shore Roba; David Rojas-Rueda; Luca Ronfani; Rajesh Sagar; Juan Ramon Sanabria; Muktar Sano Kedir Mohammed; Itamar S Santos; Maheswar Satpathy; Monika Sawhney; Ben Schöttker; David C Schwebel; James G Scott; Sadaf G Sepanlou; Amira Shaheen; Masood Ali Shaikh; June She; Rahman Shiri; Ivy Shiue; Inga Dora Sigfusdottir; Jasvinder Singh; Naris Silpakit; Alison Smith; Chandrashekhar Sreeramareddy; Jeffrey D Stanaway; Dan J Stein; Caitlyn Steiner; Muawiyyah Babale Sufiyan; Soumya Swaminathan; Rafael Tabarés-Seisdedos; Karen M Tabb; Fentaw Tadese; Mohammad Tavakkoli; Bineyam Taye; Stephanie Teeple; Teketo Kassaw Tegegne; Girma Temam Shifa; Abdullah Sulieman Terkawi; Bernadette Thomas; Alan J Thomson; Ruoyan Tobe-Gai; Marcello Tonelli; Bach Xuan Tran; Christopher Troeger; Kingsley N Ukwaja; Olalekan Uthman; Tommi Vasankari; Narayanaswamy Venketasubramanian; Vasiliy Victorovich Vlassov; Elisabete Weiderpass; Robert Weintraub; Solomon Weldemariam Gebrehiwot; Ronny Westerman; Hywel C Williams; Charles D A Wolfe; Rachel Woodbrook; Yuichiro Yano; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Z Younis; Chuanhua Yu; Maysaa El Sayed Zaki; Elias Asfaw Zegeye; Liesl Joanna Zuhlke; Christopher J L Murray; Theo Vos Journal: JAMA Pediatr Date: 2017-06-01 Impact factor: 16.193
Authors: Hmwe H Kyu; Christine Pinho; Joseph A Wagner; Jonathan C Brown; Amelia Bertozzi-Villa; Fiona J Charlson; Luc Edgar Coffeng; Lalit Dandona; Holly E Erskine; Alize J Ferrari; Christina Fitzmaurice; Thomas D Fleming; Mohammad H Forouzanfar; Nicholas Graetz; Caterina Guinovart; Juanita Haagsma; Hideki Higashi; Nicholas J Kassebaum; Heidi J Larson; Stephen S Lim; Ali H Mokdad; Maziar Moradi-Lakeh; Shaun V Odell; Gregory A Roth; Peter T Serina; Jeffrey D Stanaway; Awoke Misganaw; Harvey A Whiteford; Timothy M Wolock; Sarah Wulf Hanson; Foad Abd-Allah; Semaw Ferede Abera; Laith J Abu-Raddad; Fadia S AlBuhairan; Azmeraw T Amare; Carl Abelardo T Antonio; Al Artaman; Suzanne L Barker-Collo; Lope H Barrero; Corina Benjet; Isabela M Bensenor; Zulfiqar A Bhutta; Boris Bikbov; Alexandra Brazinova; Ismael Campos-Nonato; Carlos A Castañeda-Orjuela; Ferrán Catalá-López; Rajiv Chowdhury; Cyrus Cooper; John A Crump; Rakhi Dandona; Louisa Degenhardt; Robert P Dellavalle; Samath D Dharmaratne; Emerito Jose A Faraon; Valery L Feigin; Thomas Fürst; Johanna M Geleijnse; Bradford D Gessner; Katherine B Gibney; Atsushi Goto; David Gunnell; Graeme J Hankey; Roderick J Hay; John C Hornberger; H Dean Hosgood; Guoqing Hu; Kathryn H Jacobsen; Sudha P Jayaraman; Panniyammakal Jeemon; Jost B Jonas; André Karch; Daniel Kim; Sungroul Kim; Yoshihiro Kokubo; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G Anil Kumar; Anders Larsson; Janet L Leasher; Ricky Leung; Yongmei Li; Steven E Lipshultz; Alan D Lopez; Paulo A Lotufo; Raimundas Lunevicius; Ronan A Lyons; Marek Majdan; Reza Malekzadeh; Taufiq Mashal; Amanda J Mason-Jones; Yohannes Adama Melaku; Ziad A Memish; Walter Mendoza; Ted R Miller; Charles N Mock; Joseph Murray; Sandra Nolte; In-Hwan Oh; Bolajoko Olubukunola Olusanya; Katrina F Ortblad; Eun-Kee Park; Angel J Paternina Caicedo; Scott B Patten; George C Patton; David M Pereira; Norberto Perico; Frédéric B Piel; Suzanne Polinder; Svetlana Popova; Farshad Pourmalek; D Alex Quistberg; Giuseppe Remuzzi; Alina Rodriguez; David Rojas-Rueda; Dietrich Rothenbacher; David H Rothstein; Juan Sanabria; Itamar S Santos; David C Schwebel; Sadaf G Sepanlou; Amira Shaheen; Rahman Shiri; Ivy Shiue; Vegard Skirbekk; Karen Sliwa; Chandrashekhar T Sreeramareddy; Dan J Stein; Timothy J Steiner; Lars Jacob Stovner; Bryan L Sykes; Karen M Tabb; Abdullah Sulieman Terkawi; Alan J Thomson; Andrew L Thorne-Lyman; Jeffrey Allen Towbin; Kingsley Nnanna Ukwaja; Tommi Vasankari; Narayanaswamy Venketasubramanian; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Elisabete Weiderpass; Robert G Weintraub; Andrea Werdecker; James D Wilkinson; Solomon Meseret Woldeyohannes; Charles D A Wolfe; Yuichiro Yano; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Z Younis; Chuanhua Yu; Maysaa El Sayed Zaki; Mohsen Naghavi; Christopher J L Murray; Theo Vos Journal: JAMA Pediatr Date: 2016-03 Impact factor: 16.193