Objectives
Anemia has remained a serious public health problem in Cambodia over the last decades. To determine causal factors for anemia in Cambodian women and children, we conducted a national micronutrient survey linked to the Cambodian Demographic Health Survey (CDHS-2014)
Methods
One-sixth of households with children less than5 years of age who had participated in the CDHS-2014 were revisited within 2 months to obtain a blood, feces and urine sample for determination of micronutrient status, hemoglobinopathy disorders and intestinal parasites. Data on micronutrient status was available for 1526 subjects (801 children and 725 mothers).
Results
Prevalence of anemia was high in mothers (43%) and children (53%). Abnormal hemoglobin patterns were found in >50% of the subjects. In the mothers, prevalence of low plasma concentrations of ferritin, RBP or vitamin B12 were <5%, whereas 17.8% had low vitamin B9 concentrations (<10 nmol/L). In the children, the prevalence of low plasma concentrations of ferritin, RBP, vitamin B12 or vitamin B9 were <10%. In mothers, only iron deficiency (ferritin <15 mg/L) was associated with anemia, whereas in children, iron and zinc deficiency, hemoglobinopathy and hookworm were associated with anemia. However, iron deficiency anemia was only prevalent in children <2 yrs of age. In mothers and children, respectively 30% and 50% of the anemia remained unexplained.
Conclusions
The very high prevalence of anemia in Cambodian women and children cannot be explained solely by micronutrient deficiencies and hemoglobin disorders. Micronutrient interventions to improve anemia prevalence are likely to have limited impact in the Cambodian setting.
