Micronutrients Associated With Anemia in School-age Children and Adolescents 2005–2018: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project
Bibliographic record
Abstract
BACKGROUND School-age children and adolescents may be at risk for anemia through demands on micronutrients required for growth and maturation. OBJECTIVE This multi-country analysis examined the burden of anemia in children 5-19 y by sex and age category and associations with micronutrient deficiencies, inflammation, and BMI. METHODS Children 5-19 y from surveys in the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project were included with hemoglobin, at least one micronutrient (iron, vitamin A, folate, vitamin B 12 , or zinc) and inflammation biomarker, and n >100 per survey. Factors with bivariate relationships with anemia ( P < 0.1) were included in multivariable modified Poisson regression models to examine the attributable burden of anemia. RESULTS This analysis included 54,534 children from 17 surveys in 16 countries (16 surveys for 15-19 y; 9 surveys for 10-14 y; 8 surveys for 5-9 y). Median overall anemia prevalence was 16% (range: 5% in Ecuador, UK, and US to 59% in Côte d'Ivoire) with the highest burden in 15-19 y females (24%). In most surveys, anemia prevalence did not differ by sex for children 5-14 y, and median anemia prevalence was lower in children 10-14 y (7%) than 5-9 y (9%) or 15-19 y (22%). In most surveys, higher anemia prevalence was associated ( P < 0.05) with iron deficiency (15%) (Prevalence Ratios [PR] 1.6-14.2: 5-9 y, 4-of-7 surveys; 10-14 y, 6-of-6 surveys; 15-19 y, 13-of-14 surveys), vitamin A deficiency (2%) (PR 1.8-3.0: 5-9 y, 2-of-2 surveys; 10-14 y, 2-of-3 surveys; 15-19 y, 2-of-3 surveys), and inflammation (13%) (PR 1.4-2.4: 5-9 y, 4-of-4 surveys; 10-14 y, 2-of-4 surveys; 15-19 y, 6-of-8 surveys). Folate, vitamin B 12 , zinc, and BMI had weak, variable associations with anemia. CONCLUSIONS Iron deficiency and vitamin A deficiency were consistently associated with anemia in school-age children and adolescents, whereas inflammation and other micronutrients had context-dependent associations. This research underscores the importance of examining multiple micronutrients associated with anemia in the context of factors like country, age, and sex.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".