{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:26:07Z","timestamp":1774380367154,"version":"3.50.1"},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,4]]},"abstract":"<jats:p>Anemia represents a substantial problem for children living in areas with limited resources and significant parasite burden. We performed a cross-sectional study of 254 Kenyan preschool- and early school-age children in a setting endemic for multiple chronic parasitic infections to explore mechanisms of their anemia. Complete venous blood cell counts revealed a high prevalence of local childhood anemia (79%). Evaluating the potential links between low hemoglobin and socioeconomic factors, nutritional status, hemoglobinopathy, and\/or parasite infection, we identified age &lt; 9 years (odds ratio [OR]: 12.0, 95% confidence interval [CI]: 4.4, 33) and the presence of asymptomatic malaria infection (OR: 6.8, 95% CI: 2.1, 22) as the strongest independent correlates of having anemia. A total of 130\/155 (84%) of anemic children with iron studies had evidence of iron-deficiency anemia (IDA), 16% had non-IDA; 50\/52 of additionally tested anemic children met soluble transferrin-receptor (sTfR) criteria for combined anemia of inflammation (AI) with IDA. Children in the youngest age group had the greatest odds of iron deficiency (OR: 10.0, 95% CI: 3.9, 26). Although older children aged 9\u201311 years had less anemia, they had more detectable malaria, <jats:italic>Schistosoma<\/jats:italic> infection, hookworm, and proportionately more non-IDA. Anemia in this setting appears multifactorial such that chronic inflammation and iron deficiency need to be addressed together as part of integrated management of childhood anemia.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0353","type":"journal-article","created":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T02:18:47Z","timestamp":1441073927000},"page":"1099-1105","source":"Crossref","is-referenced-by-count":15,"title":["Anemia Among Children Exposed to Polyparasitism in Coastal Kenya"],"prefix":"10.4269","volume":"93","author":[{"given":"Alicia","family":"Chang Cojulun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amaya L.","family":"Bustinduy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura J.","family":"Sutherland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Mungai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Mutuku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Muchiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uriel","family":"Kitron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles H.","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Iron Deficiency Anaemia: Assessment, Prevention and Control: A Guide for Programme Managers","author":"World Health Organization","year":"2001"},{"key":"ref2","series-title":"Worldwide Prevalence of Anaemia 1993\u20132005","author":"Benoist","year":"2008"},{"key":"ref3","series-title":"BMJ","first-page":"1389","article-title":"Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: double blind, placebo controlled study","volume":"323","author":"Stoltzfus","year":"2001"},{"key":"ref4","series-title":"Psychol Bull","first-page":"171","article-title":"\u201cStupidity or worms\u201d: do intestinal worms impair mental performance?","volume":"121","author":"Watkins","year":"1997"},{"key":"ref5","series-title":"Trends Parasitol","first-page":"386","article-title":"Human schistosomiasis and anemia: the relationship and potential mechanisms","volume":"21","author":"Friedman","year":"2005"},{"key":"ref6","series-title":"Am J Clin Nutr","first-page":"462","article-title":"In Ivorian school-age children, infection with hookworm does not reduce dietary iron absorption or systemic iron utilization, whereas afebrile Plasmodium falciparum infection reduces iron absorption by half","volume":"101","author":"Glinz","year":"2015"},{"key":"ref7","series-title":"J Nutr","first-page":"348","article-title":"Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children","volume":"134","author":"Stoltzfus","year":"2004"},{"key":"ref8","series-title":"N Engl J Med","first-page":"1011","article-title":"Anemia of chronic disease","volume":"352","author":"Weiss","year":"2005"},{"key":"ref9","series-title":"Ann Trop Med Parasitol","first-page":"671","article-title":"Polyparasitism on the Kenya coast. 1. 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