Objective: To investigate risk factors for iron-deficiency anemia in children and adolescents (7 to 17 years of age) with intestinal helminthic infections.
Methods: A cross-sectional study was carried out with 1 709 children and adolescents living in Jequié, a town in the state of Bahia, Brazil, who had mild to moderate infection by Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, or hookworms. We obtained data concerning hemoglobin levels (using a portable hemoglobinometer), dietary habits (24-hour dietary recall), parasitic infections (Kato-Katz method), sanitary conditions (water supply, sewage connection, garbage collection), housing conditions (type of construction, number of persons per room), income, and amount of schooling of the parents or guardians. The risk factors for anemia were studied based on a hierarchical model of causality.
Results: The prevalence of parasitic infection was 74.8% for T. trichiura, 63.0% for A. lumbricoides, 55.5% for S. mansoni, and 15.7% for hookworms. Among the children and adolescents studied 32.2% were anemic. After adjustment for confounding variables, the results of the multivariate analysis showed that the following variables were significantly associated with anemia: per capita family income below US$ 27 (equal to one fourth of the Brazilian minimum wage), male sex, age of 7 to 9 years, and inadequate intake of bioavailable iron.
Conclusions: The initiatives to control anemia in the group at greatest risk, as identified in this study, should seek to increase the consumption of iron-rich foods, boost the bioavailability of the iron ingested, and improve socioenvironmental conditions.