Resumen

SAN MIGUEL SIMBRON, José Luis; MUNOZ VERA, Maruska; URTEAGA MAMANI, Noelia  y  ESPEJO ALIAGA, Elva. Deficiencia de hierro y anemia en escolares residentes de gran altitud: asociación con infecciónIron deficiency and anemia in high altitude school children: Association with infection. Cuad. - Hosp. Clín. [online]. 2014, vol.55, n.2, pp. 24-33. ISSN 1652-6776.

Research Question: What is the association between iron deficiency, anemia and infections in high altitude residents school children in peripheral areas of La Paz city, Bolivia, 2011? Objective: To determinate the association between iron deficiency, anemia and infections in high altitude residents school children in peripheral areas of La Paz city, Bolivia, 2011. Methods: A descriptive, transversal study was conducted in urban and periurban areas of La Paz city at 3700 meters over sea level. The study included 84 school children between 6 to 13 year's old. A pediatric clinic examination and anthropometric measurements was performed, hemoglobin, serum ferritin, ultrasensitive PCR and Interleukin-6 was determined by conventional methods. Finally a hidden infections survey was applied. Results: We found obesity in 8% of school children defined by BMI-Z score > 2 SD, stunting in12 % (Height for age Z-score< -2 SD), waist circumference by age and sex was elevated in 24 school children (28,5%) with male predominance. According to high altitude hemoglobin cutoff, we found 52.4% of anemia. Serum ferritin levels (iron reservations) demonstrate iron deficiency in 95.2%, being twice as anemia defined by hemoglobin. We found high levels of IL-6 (=> 10 pg/mL) in 84 cases (100%) with male predominance, associated through pediatric examination with inflammatory process in 86.9% of the cases. There was correlation between serum ferritin and ultrasensitive PCR (r = 0,372, p< 0,001). Subclinical infection was decay in 25 cases, 2 infections (decay and otitis) in 37 cases and 3 infections (decay, acute respiratory infections, conjunctivitis or dermatitis) in 12 cases. Conclusions: In our environment, the anemia iron deficiency and subclinical infections coexist in high proportion. Exist anemia in a halfof al l school children, and iron deficiency nearly 100%. IL-6 was higher in all school children, showing a immune response increased by subclinical infection. We verified a correlation between ferritin and PCR.

Palabras llave : Iron deficiency; anemia; high altitude; school children; infection markers and subclinical infection.