Author:
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1.
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ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68: 68–77.
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Bonfoh B, Raso G, Koné I, Dao D, Girardin O, Cissé G, Zinsstag J, Utzinger J, Tanner M, 2011. Research in a war zone. Nature 474: 569–571.
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Becker SL, Sieto B, Silué KD, Adjossan L, Koné S, Hatz C, Kern WV, N'Goran EK, Utzinger J, 2011. Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting. PLoS Negl Trop Dis 5: e1292.
-
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N'Goran EK, Diabate S, Utzinger J, Sellin B, 1997. Changes in human schistosomiasis levels after the construction of two large hydroelectric dams in central Côte d'Ivoire. Bull World Health Organ 75: 541–545.
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N'Goran EK, Utzinger J, N'Guessan AN, Müller I, Zamblé K, Lohourignon KL, Traoré M, Sosthène BA, Lengeler C, Tanner M, 2001. Reinfection with Schistosoma haematobium following school-based chemotherapy with praziquantel in four highly endemic villages in Côte d'Ivoire. Trop Med Int Health 6: 817–825.
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Booth M, Vounatsou P, N'Goran EK, Tanner M, Utzinger J, 2003. The influence of sampling effort and the performance of the Kato-Katz technique in diagnosing Schistosoma mansoni and hookworm co-infections in rural Côte d'Ivoire. Parasitology 127: 525–531.
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Etiology of Anemia Among Infants, School-Aged Children, and Young Non-Pregnant Women in Different Settings of South-Central Côte d'Ivoire
Aurélie A. Righetti
Aurélie A. Righetti
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Ahou-Yah G. Koua
Ahou-Yah G. Koua
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Lukas G. Adiossan
Lukas G. Adiossan
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Dominik Glinz
Dominik Glinz
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Richard F. Hurrell
Richard F. Hurrell
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Eliézer K. N'Goran
Eliézer K. N'Goran
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Sébastien Niamké
Sébastien Niamké
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Rita Wegmüller
Rita Wegmüller
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Jürg Utzinger
Jürg Utzinger
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire; Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire; Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Anemia affects one-quarter of the world's population, but its etiology remains poorly understood. We determined the prevalence of anemia and studied underlying risk factors in infants (6–23 months), young school-aged children (6–8 years), and young non-pregnant women (15–25 years) in south-central Côte d'Ivoire. Blood, stool, and urine samples were subjected to standardized, quality-controlled methods. We found high prevalence of anemia, malaria, inflammation, and deficiencies of iron, riboflavin, and vitamin A but low prevalence and intensities of soil-transmitted helminth and schistosome infections. Multivariate regression analysis revealed significant associations between anemia and Plasmodium falciparum for infants, inflammation for school-aged children, and cellular iron deficiency for both school-aged children and non-pregnant women. Women with riboflavin deficiency had significantly lower odds of anemia. Our findings call for interventions to protect infants from malaria, improved intake of dietary iron, better access to health care, and health education.
Author Notes
Financial support: This work was supported by the Swiss National Science Foundation (project no. IZ70Z0_123900). Start-up funding for the establishment and running of the Taabo HDSS has been granted by Fairmed. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Authors' addresses: Aurélie A. Righetti and Jürg Utzinger, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland, E-mails: aurelie.righetti@unibas.ch and juerg.utzinger@unibas.ch. Ahou-Yah G. Koua and Sébastien Niamké, Laboratoire de Biotechnologies, Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire, E-mails: kouayahgisele@yahoo.fr and niamkes@yahoo.fr. Lukas G. Adiossan, Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire, E-mail: adiossanlukas@yahoo.fr. Dominik Glinz, Richard F. Hurrell, and Rita Wegmüller, Laboratory of Human Nutrition, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland, E-mails: dominik.glinz@hest.ethz.ch, richard.hurrell@hest.ethz.ch, and rita.wegmueller@hest.ethz.ch. Eliézer K. N'Goran, Laboratoire de Zoologie Biologie Animale, Unité de Formation et de Recherche Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire, E-mail: eliezerngoran@yahoo.fr.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B, 2009. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 12: 444–454.
-
2.
Tolentino K, Friedman JF, 2007. An update on anemia in less developed countries. Am J Trop Med Hyg 77: 44–51.
-
3.
WHO/UNICEF/UNU, 2001. Iron Deficiency Anemia: Assessment, Prevention and Control. Geneva: World Health Organization.
-
4.
Rohner F, Zimmermann MB, Amon RJ, Vounatsou P, Tschannen AB, N'Goran EK, Nindjin C, Cacou MC, Te-Bonle MD, Aka H, Sess DE, Utzinger J, Hurrell RF, 2010. In a randomized controlled trial of iron fortification, anthelmintic treatment, and intermittent preventive treatment of malaria for anemia control in Ivorian children, only anthelmintic treatment shows modest benefit. J Nutr 140: 635–641.
-
5.
Wegmüller R, Camara F, Zimmermann MB, Adou P, Hurrell RF, 2006. Salt dual-fortified with iodine and micronized ground ferric pyrophosphate affects iron status but not hemoglobin in children in Côte d'Ivoire. J Nutr 136: 1814–1820.
-
6.
Staubli Asobayire F, Adou P, Davidsson L, Cook JD, Hurrell RF, 2001. Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Côte d'Ivoire. Am J Clin Nutr 74: 776–782.
-
7.
ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, Friedman JF, Shi YP, Kolczak MS, Lal AA, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68: 68–77.
-
8.
Bonfoh B, Raso G, Koné I, Dao D, Girardin O, Cissé G, Zinsstag J, Utzinger J, Tanner M, 2011. Research in a war zone. Nature 474: 569–571.
-
9.
Becker SL, Sieto B, Silué KD, Adjossan L, Koné S, Hatz C, Kern WV, N'Goran EK, Utzinger J, 2011. Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting. PLoS Negl Trop Dis 5: e1292.
-
10.
N'Goran EK, Diabate S, Utzinger J, Sellin B, 1997. Changes in human schistosomiasis levels after the construction of two large hydroelectric dams in central Côte d'Ivoire. Bull World Health Organ 75: 541–545.
-
11.
WHO, 1990. Adequacy of Sample Size in Health Studies. New York: John Wiley & Sons.
-
12.
Katz N, Chaves A, Pellegrino J, 1972. A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop São Paulo 14: 397–400.
-
13.
WHO, 1991. Basic Laboratory Methods in Medical Parasitology. Geneva: World Health Organization.
-
14.
Schneider RG, 1974. Differentiation of electrophoretically similar hemoglobins—such as S, D, G, and P; or A2, C, E, and O—by electrophoresis of the globin chains. Clin Chem 20: 1111–1115.
-
15.
Dror Y, Stern F, Komarnitsky M, 1994. Optimal and stable conditions for the determination of erythrocyte glutathione reductase activation coefficient to evaluate riboflavin status. Int J Vitam Nutr Res 64: 257–262.
-
16.
Sauberlich H, 1999. Vitamin B-2. Laboratory Tests for the Assessment of Nutritional Status, 2nd Ed. Boca Raton, FL: CRC Press, 55–69.
-
17.
Erhardt JG, Estes JE, Pfeiffer CM, Biesalski HK, Craft NE, 2004. Combined measurement of ferritin, soluble transferrin receptor, retinol binding protein, and C-reactive protein by an inexpensive, sensitive, and simple sandwich enzyme-linked immunosorbent assay technique. J Nutr 134: 3127–3132.
-
18.
Tanumihardjo SA, Permaesih D, Muhilal, 2004. Vitamin A status and hemoglobin concentrations are improved in Indonesian children with vitamin A and deworming interventions. Eur J Clin Nutr 58: 1223–1230.
-
19.
Cook JD, Skikne BS, Baynes RD, 1993. Serum transferrin receptor. Annu Rev Med 44: 63–74.
-
20.
WHO, 2011. Serum Retinol Concentrations for Determining the Prevalence of Vitamin A Deficiency in Populations. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization.
-
21.
Gorstein JL, Dary O, Pongtorn, Shell-Duncan B, Quick T, Wasanwisut E, 2008. Feasibility of using retinol-binding protein from capillary blood specimens to estimate serum retinol concentrations and the prevalence of vitamin A deficiency in low-resource settings. Public Health Nutr 11: 513–520.
-
22.
Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV, 2010. Serum ferritin: past, present and future. Biochim Biophys Acta 1800: 760–769.
-
23.
Thurnham DI, McCabe GP, Northrop-Clewes CA, Nestel P, 2003. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis. Lancet 362: 2052–2058.
-
24.
N'Goran EK, Utzinger J, N'Guessan AN, Müller I, Zamblé K, Lohourignon KL, Traoré M, Sosthène BA, Lengeler C, Tanner M, 2001. Reinfection with Schistosoma haematobium following school-based chemotherapy with praziquantel in four highly endemic villages in Côte d'Ivoire. Trop Med Int Health 6: 817–825.
-
25.
Booth M, Vounatsou P, N'Goran EK, Tanner M, Utzinger J, 2003. The influence of sampling effort and the performance of the Kato-Katz technique in diagnosing Schistosoma mansoni and hookworm co-infections in rural Côte d'Ivoire. Parasitology 127: 525–531.
-
26.
WHO, 1998. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level. Geneva: World Health Organization.
-
27.
Marti H, Koella JC, 1993. Multiple stool examinations for ova and parasites and rate of false-negative results. J Clin Microbiol 31: 3044–3045.
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