Changes in hemoglobin levels with age and altitude in preschool‐aged children in Peru: the assessment of two individual‐based national databases

• Published in: Annals of the New York Academy of Sciences 2021-03, Vol.1488 (1), p.67-82
• Main Authors: Gonzales, Gustavo F., Tapia, Vilma, Vásquez‐Velásquez, Cinthya
• Format: Article
• Language: English
• Subjects: Age Factors; Altitude; altitude adjustment; Anemia; Anemia - blood; Anemia - diagnosis; Anemia - epidemiology; Child, Preschool; Children; Cross-Sectional Studies; Databases, Factual - trends; environmental health; erythrocytosis; Female; Hemoglobin; Hemoglobins - metabolism; Humans; Infant; Male; Measuring instruments; Peru - epidemiology; Sea level; Sea level changes
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/nyas.14520

According to the World Health Organization, the cutoff hemoglobin (Hb) value for defining anemia is 11 g/dL in preschool‐aged children, and Hb measurements should be corrected above an altitude of 1000 meters. This study sought to determine the altitude at which the Hb value increases compared with that at sea level, Hb changes with age and region in Peru, the prevalence of anemia according to three different models used to correct Hb for altitude, and the association of the Hb value with stunting. Two individual‐based Peruvian national databases were analyzed. Hb increased from an altitude of 375 meters. Hb concentration was lower at younger ages and higher at older ages. The increase in Hb with increasing altitude was lower in southern Peru. Implementing the different models for Hb measurement correction resulted in a higher and lower prevalence of anemia at altitudes >2500 and