Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers

Objective: To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil. Methods: A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months. Nutritional iron status was assessed in terms of body iron reserves (serum ferritin), transferrinemia (serum iron, total iron binding capacity, and transferrin saturation %), erythropoiesis (free erythrocyte protoporphyrin) and hemoglobin production (hemoglobin). Results: The prevalence of anemia (hemoglobin < 11.0 g/dL) was 55.6% (95%CI 47.3-63.5), evidence was found of depleted iron stocks (serum ferritin < 12.0 ng/mL) in 30.8% (95%CI 22.9-39.3), low transferrinemia levels (transferrin saturation % < 16) in 60.1% (95%CI 51.7-68.0) and deficient erythropoiesis (free erythrocyte protoporphyrin > 40 mu mol/mol heme) in 69.6% (95%CI 61.0-77.1) of the children. Iron parameters were not correlated with sex (p > 0.05). However, children < 24 months exhibited lower hemoglobin concentrations (p < 0.00) and higher levels of free erythrocyte protoporphyrin (p < 0.000) and total iron binding capacity (p < 0.001) when compared with children > 24 months. The significant correlation observed between reserves, transferrinemia and erythropoiesis is a finding that is compatible with the expected lifecycle of iron in the body. Conclusions: Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context.