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Open Access Highly Accessed Research article

Prevalence of anemia and deficiency of iron, folic acid, and zinc in children younger than 2 years of age who use the health services provided by the Mexican Social Security Institute

Ximena Duque1, Sergio Flores-Hernández1, Samuel Flores-Huerta2, Ignacio Méndez-Ramírez3, Sergio Muñoz4, Bernardo Turnbull1, Gloria Martínez-Andrade1, Rosa I Ramos1, Marco González-Unzaga1, María E Mendoza1 and Homero Martínez56*

Author Affiliations

1 Unidad de Investigación en Epidemiología Nutricional, Instituto Mexicano del Seguro Social, Mexico D.F., Mexico

2 Departamento de Salud Comunitaria, Hospital Infantil de México "Federico Gómez", Mexico D.F., Mexico

3 Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, Mexico D.F., Mexico

4 Facultad de Medicina, Universidad de la Frontera, Temuco, Chile

5 RAND, Santa Monica, CA, USA

6 Dirección de Investigación Médica, Hospital Infantil de México "Federico Gómez", Mexico D.F., Mexico

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BMC Public Health 2007, 7:345  doi:10.1186/1471-2458-7-345

Published: 30 November 2007

Abstract

Background

In Mexico, as in other developing countries, micronutrient deficiencies are common in infants between 6 and 24 months of age and are an important public health problem. The objective of this study was to determine the prevalence of anemia and of iron, folic acid, and zinc deficiencies in Mexican children under 2 years of age who use the health care services provided by the Mexican Institute for Social Security (IMSS).

Methods

A nationwide survey was conducted with a representative sample of children younger than 2 years of age, beneficiaries, and users of health care services provided by IMSS through its regular regimen (located in urban populations) and its Oportunidades program (services offered in rural areas). A subsample of 4,955 clinically healthy children was studied to determine their micronutrient status. A venous blood sample was drawn to determine hemoglobin, serum ferritin, percent of transferrin saturation, zinc, and folic acid. Descriptive statistics include point estimates and 95% confidence intervals for the sample and projections for the larger population from which the sample was drawn.

Results

Twenty percent of children younger than 2 years of age had anemia, and 27.8% (rural) to 32.6% (urban) had iron deficiency; more than 50% of anemia was not associated with low ferritin concentrations. Iron stores were more depleted as age increased. Low serum zinc and folic acid deficiencies were 28% and 10%, respectively, in the urban areas, and 13% and 8%, respectively, in rural areas. The prevalence of simultaneous iron and zinc deficiencies was 9.2% and 2.7% in urban and rural areas. Children with anemia have higher percentages of folic acid deficiency than children with normal iron status.

Conclusion

Iron and zinc deficiencies constitute the principal micronutrient deficiencies in Mexican children younger than 2 years old who use the health care services provided by IMSS. Anemia not associated with low ferritin values was more prevalent than iron-deficiency anemia. The presence of micronutrient deficiencies at this early age calls for effective preventive public nutrition programs to address them.