{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:32:05Z","timestamp":1790742725330,"version":"4.1.0"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3\u201316 years of age attending public schools were invited to participate. We enrolled children 3\u201316 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (\u00b13.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35\u20133,497) meters. The mean hemoglobin level was 15 (\u00b11.15) mg\/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2\u20133.6], <jats:italic>P<\/jats:italic> &lt;0.001) and serum transferrin saturation (OR 2.8 [95% CI 2\u20133.9], <jats:italic>P<\/jats:italic> &lt;0.001). Younger age (OR 0.85 [95% CI 0.82\u20130.89], <jats:italic>P<\/jats:italic> &lt;0.001), stunting (OR 0.68 [95% CI 0.59\u20130.79], <jats:italic>P<\/jats:italic> &lt;0.001), education of the mother (OR 0.94 [95% CI 0.91\u20130.98], <jats:italic>P<\/jats:italic> &lt;0.005), and low eosinophils (OR 0.49 [95% CI 0.26\u20130.9], <jats:italic>P<\/jats:italic> = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0666","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T19:25:21Z","timestamp":1711481121000},"page":"1014-1020","source":"Crossref","is-referenced-by-count":5,"title":["Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among Children Living at High Elevation in Cusco, Peru"],"prefix":"10.4269","volume":"110","author":[{"given":"Maria A.","family":"Caravedo","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Morales","sequence":"additional","affiliation":[{"name":"Sede Cusco \u2013 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Lopez","sequence":"additional","affiliation":[{"name":"Sede Cusco \u2013 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Clinton","family":"White","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel M.","family":"Cabada","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas;"},{"name":"Sede Cusco \u2013 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","year":"2011"},{"key":"b2","series-title":"Public Health Nutr","first-page":"444","article-title":"Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993\u20132005","volume":"12","author":"McLean","year":"2009"},{"key":"b3","series-title":"Rev Saude Publica","first-page":"99","article-title":"Prevalence of anemia among Indigenous children 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