P0606 - Prevalence of anemia in hospitalized pediatric patients in an urban community hospital

Background: Anemia, mainly iron deficiency (IDA), is a global public health problem. The high prevalence of IDA in young children is worrisome since there are studies showing long-term adverse effects on cognitive skills and neuromaturation, which is preventable.

Objective: To establish the prevalence of anemia among the pediatric patients admitted with diagnoses other than anemia to the BronxCare Health System pediatric inpatient unit in the years 2017 and 2018.

Design/methods: This was a retrospective chart review of children 6 months-18 years.
The study used the WHO hemoglobin thresholds to define anemia: (and MCV, RDW, RBC values)
•Children 0.5 to 4.9 years: <11 g/dL
• 5 to 11.9 years: <11.5 g/dL
• 12 to 14.9 years: <12 g/dL
•Non-pregnant girls ≥15 years: <12 g/dL
•Boys ≥15 years: <13 g/dL
Exclusion criteria were presence of hemoglobinopathies, chronic disease (such as IBD, TB, cancers, and sickle cell), malaria, and pregnancy.

Results: Out of 2771 patients, the overall prevalence of anemia was 19.8% (548/2771) (Table 1). 352 (12.7%) had mild anemia, 189 (6.8%) moderate, and 7 (0.3%) severe.
There was a statistically significant increase in anemia with an increase in age, P <0.031.
The age groups 12-14.9 and ≥ 15 years had the highest prevalence of anemia, 26.6% and 24.7% respectively. There were no significant association between the prevalence and race. Rate of anemia was significantly higher for females (24.2%) than for males (16.3%).

Discussion: The overall prevalence of anemia was 19.8%, which is a mild public health problem as per WHO (< 5% no problem, 5-19.9% mild problem, 20-39.9% moderate, ≥ 40% severe). Previous studies show that children under 5 years and females are high-risk for anemia. Prevalence of anemia for the U.S. (including adults) is 5.6%. Prevalence of anemia in U.S. preschool children is 8.5%, and in New York City (NYC) it is 9.5%. In our study it was 19.3% (Table 1). Surprisingly the school-age children (12–18 years) had higher prevalence of anemia compared to the youngest age group (0.5 – 4.9 years). The lowest prevalence of anemia was in the 5-11.9 years age group. Females had higher rates of anemia than males, which is consistent with previous findings. The rates of anemia did not differ significantly by race, in large part because there are so many different and undisclosed racial groups in our study.

Conclusions: The prevalence of anemia in our study was higher than previously reported. Based on our results, we recommend screening for anemia in older age groups (≥ 12 years) during health care visits.