Multidimensional approach to iron deficiency anemia in infants younger than two years old in Northeast Argentina. 2004-2005.

Introduction: The prevalence of iron deficiency anemia (IDA) is high among infants younger than two years old, especially in disadvantaged populations.

Objective: To study certain social and biological determinants associated with IDA in children aged 12 to 23.9 months old in Northeast Argentina in the 2004-2005 period.

Methodology: Cross-sectional design. Explanatory outcome measures were organized in three levels: distal (food assistance, unmet basic needs, and head of household with medical coverage), intermediate (breastfeeding, iron supplementation, and iron intake), and proximal (nutritional status, gestational age, birth weight, age, and sex). The association between selected outcome measures and IDA (Hb< 11 g/dL, ferritin < 12 ng/dL, WBCs < 15 000/mL) was assessed using logistic regression models with hierarchical selection of outcome measures.

Results: Lack of food assistance (OR: 1.85 [1.14, 3.02]) and inadequate iron intake (OR: 2.60 [1.18, 5.71]) were associated with IDA. The prevalence of anemia was higher with a younger gestational age (OR: 0.89 [0.81, 0.97]) and a younger age in months old (OR: 0.90 [0.84, 0.96]).

Conclusions: This study evidences the strong and complex relationship between social determinants and anemia, a disease that is highly prevalent among young children. Food assistance programs may have a protective effect against IDA; consumption of fortified foods may improve iron intake in infants younger than two years old. In addition, emphasis is placed on the need to assess the impact of policies on population health.